Celva / Joint pain / Knee pain

Medically reviewed by the Celva medical team · June 2026

§ 001 · Knee · MSC therapy

A knee replacement
is one option.

For knee osteoarthritis, meniscus degeneration, and cartilage loss, MSC therapy is a legitimate path to review before you book the operating room. The determining factor is what your imaging says, not what's convenient to recommend.

Most common
#1 indication

The knee is the joint we screen most. Typically early-to-moderate OA or a surgical recommendation in hand.

Response window
4–12 wks

When most knee patients first notice meaningful change. Peak around 4–6 months.

§ 002 · Candidacy

You've been told
surgery is next.

Knee replacement is framed as inevitable once degeneration reaches a certain grade. Sometimes that's accurate. Often it isn't. By the time a knee is arthritic, the tendons, ligaments, and muscles around it are usually strained too, and that's a large part of the pain. We treat the whole joint, so candidacy is about more than how much cartilage is left.

Moderate osteoarthritis, meniscus degeneration, ligament and tendon strain, and early cartilage loss frequently respond, because we treat the supporting structures around the knee, not only the cartilage inside it. For advanced bone-on-bone arthritis, the expected response is lower, but we will still consider treating you if you want to delay or avoid joint replacement.

If your surgeon has recommended replacement, the evaluation is still a reasonable next step. We will read your MRI and tell you plainly what kind of response to expect.

Strong fit

Moderate degeneration, not yet bone-on-bone

Kellgren–Lawrence II or III with preserved joint space in at least one compartment. The best response profile.

Also a fit

Meniscus damage, chronic tendinopathy, post-injury drift

Where conservative care has plateaued and PRP or cortisone hasn't held.

Not a fit

End-stage bone loss, hardware-required pathology

Grade IV OA with subchondral bone loss, ligament instability requiring reconstruction, surgery is the right tool.

§ 003 · Indications

Knee conditions
the physician team evaluates.

Every evaluation starts with Celva's physician team at Hospital Angeles, Tijuana reading your imaging and history. Not every diagnosis qualifies. Candidacy is decided on severity, structure, and your specific case.

Osteoarthritis

Knee OA (I–III)

The most common reason patients come to us. Early to moderate OA with cartilage wear but limited bone-on-bone contact.

  • Medial or lateral compartment
  • Grade II–III strongest
  • Read against MRI & weight-bearing X-ray
Soft tissue

Meniscus & cartilage

Degenerative meniscus tears, chondromalacia, and focal cartilage defects that haven't responded to conservative care.

  • Degenerative tears
  • Chondromalacia grade II–III
  • Focal defects < 2 cm²
Drift

Post-injury & tendinopathy

Accelerated degeneration after a prior ACL, MCL, or meniscus event. Chronic patellar or quadriceps tendinopathy.

  • Post-ACL osteoarthritis
  • Patellar tendinopathy
  • Refractory after PT / PRP
§ 004 · Protocol

How a knee session
actually runs.

We treat the knee as a whole joint, not just the cartilage. Under image guidance, cells go into the joint space and into the supporting structures around it: the tendons, ligaments, and muscles that hold the knee together and often drive the pain. Paracrine signaling does the rest, calming inflammation and supporting the joint's own repair machinery over weeks to months.

Joint cases like yours use bone-marrow and umbilical-cord MSCs, often in combination and sometimes with chondrocytes for cartilage support. The exact recipe, which cells, what doses, which routes, is decided by Celva's medical team after reviewing your imaging. Matched to your case, not pulled off a shelf. Why we use multiple cell types →

The entire procedure is physician-supervised at Hospital Angeles, Tijuana. Concierge transport from San Diego in the morning, discharge the same afternoon. You walk out.

Because we treat the tissues around the knee too, the first days usually bring soreness rather than instant relief. That's the healing response doing its job. We ask you to ease off the joint and let it settle; the signaling works over weeks, not hours.

01 / Screen

Imaging & candidacy

X-ray and MRI read by the attending. Degeneration grade, joint-space width, and structural integrity assessed. You'll hear either way.

~2 wks pre-op · virtual
02 / Plan

Dose & route

Cell type and dose, delivery route, and whether a same-day systemic IV is indicated, all set against your imaging and goals.

03 / Deliver

Image-guided injection

Fluoroscopic or ultrasound guidance places cells in the target compartment. Needle position confirmed before release. Local anesthetic and twilight sedation (no general): a still, comfortable patient lets the physician reach every target and place the cells precisely.

~45 min · local + twilight
04 / Synergy

Systemic IV

A second MSC dose IV in the infusion suite. The two routes compound: circulating cells are drawn toward inflammation and migrate toward the knee we just injected, reinforcing the local repair while calming inflammation body-wide.

~1 hr · monitored
05 / Follow-up

Scoring & check-ins

We score KOOS (function) and VAS (pain) at baseline, then at 4, 8, and 12 months, with a lighter pain-and-safety check-in around six weeks. Repeat imaging on return for re-treatment. Structured, not reactive.

§ 005 · Timeline

What to expect.
And what we won't promise.

No outcome guarantees. What you get is a thorough evaluation, a realistic conversation, and treatment delivered to pharmaceutical-grade standards. Here is what our clinical follow-up generally shows for knee candidates.

~ 30 days
Inflammation down, sleep better

Early reduction in NSAIDs for many patients. Pain on loading often unchanged.

~ 90 days
Measurable functional gains

KOOS function scores improve for most qualifying candidates. Patients pick back up things they had stopped doing.

~ 180 days
Peak window

Some patients report near-complete relief. Others see partial improvement. A subset benefit from a booster at this point.

12 – 36 months
Durability window

Many patients hold meaningful results for one to three years, and often longer. Duration varies with severity and biology.

The absence of dramatic change at two to four weeks is normal and expected. MSCs work through a slow paracrine process, not a pharmacologic on/off switch.

We measure progress on standardized scales: KOOS for function, VAS for pain, scored at baseline and again at 4, 8, and 12 months. Not on vibes.

The honest limit

Bone-on-bone degeneration and advanced structural failure produce a lower expected response than moderate cases. If your imaging reads that way, we'll tell you plainly what we'd expect. For patients who want to delay or avoid replacement, we'll still consider treating you; the decision is yours after an honest conversation.

§ 006 · Questions

Knee-specific
questions.

Q.01 Can MSC therapy replace knee replacement surgery?
Not a guaranteed replacement, but a legitimate option to evaluate before you commit. Patients with moderate degeneration, not yet bone-on-bone, are often the strongest candidates. Candidacy is decided by imaging review and physician evaluation.
Q.02 How long before I notice improvement?
Most knee patients begin noticing change between 4 and 12 weeks, with peak outcomes at 4 to 6 months. We score KOOS and VAS at baseline, then at 4, 8, and 12 months, with a lighter pain check-in around six weeks, so progress isn't guesswork.
Q.03 Does advanced bone-on-bone degeneration qualify?
Yes, it can qualify, with a frank conversation. End-stage Kellgren–Lawrence IV with subchondral bone loss produces a lower expected response than moderate cases. For patients who want to delay or avoid joint replacement, we'll still consider treating you; we just want you choosing with realistic expectations, not optimistic ones.
Q.04 Does the injection hurt?
We almost always use twilight sedation, and not only for comfort. When you're relaxed and still, the physician can deliver the injection precisely and place the full dose where it's needed; pain or guarding can get in the way of that. Local anesthetic is used as well, and most patients feel little to nothing. Mild soreness at the site for 24 to 48 hours is common, and the procedure itself typically runs under 45 minutes.
Q.05 Can I pair the knee injection with IV therapy the same day?
Yes. Many patients add an IV protocol on the same visit for systemic anti-inflammatory support. Whether the combination is right for you is a physician call during evaluation.
Q.06 How soon can I use the knee normally?
Plan on staying off the knee with very limited activity for the first seven to ten days while the joint is protected. From there, a slow, graded return to loading over the next two to four weeks and again at six to eight weeks. Loading too early works against the repair. Running and high-impact activity wait until the 90-day review.
§ 008 · Start here

Start with an
honest read.

A consult is a physician reviewing your imaging, history, and goals, then telling you plainly whether MSC therapy is a realistic option for your knee. If it isn't, we'll say so.

See if you're a candidate →
Not medical advice. Individual results vary. All patients undergo physician screening before treatment is recommended.