What Causes Osteoarthritis?

Osteoarthritis develops when joint cartilage breaks down faster than the body can repair it — a combination of aging, mechanical stress, and individual biological factors, rather than a single identifiable cause. Primary osteoarthritis is most commonly linked to the natural aging process, where cumulative wear and tear over the years causes cartilage to deteriorate, leading to joint pain and stiffness.

Major risk factors include:

• Excess body weight — Every extra kilogram adds disproportionate load to weight-bearing joints, particularly the knees, making this one of the most significant modifiable risk factors for osteoarthritis.
• Genetics and family history — A family history of osteoarthritis increases individual risk, suggesting an inherited component to cartilage strength and joint structure.
• Age and gender — Risk increases with age, and osteoarthritis — particularly of the knee — is more common in women, especially after menopause.
• Repetitive joint stress — Occupations or activities involving frequent kneeling, squatting, or heavy lifting place sustained mechanical stress on joints over time.
• Joint injuries — Any direct damage to the joints, whether from sports-related injuries, falls, or accidents, can accelerate cartilage breakdown and lead to earlier-onset osteoarthritis.
• Underlying joint conditions — Conditions such as Ehlers-Danlos syndrome or joint hypermobility syndrome directly affect joint structure, increasing vulnerability to cartilage breakdown.

Certain inflammatory forms of arthritis can also lead to secondary osteoarthritis:

• Rheumatoid arthritis — An autoimmune condition causing joint inflammation that can damage cartilage over time. (See our separate rheumatoid arthritis treatment program — RA and OA are distinct conditions with different treatment pathways.)
• Gout — Caused by high uric acid levels forming crystals in the joints, which can damage cartilage over time.
• Psoriatic arthritis — Often occurring alongside psoriasis, this condition causes joint inflammation that can contribute to cartilage wear.

The precise combination of causes varies from person to person — which is one reason a proper diagnostic evaluation matters before considering any treatment path, including stem cell therapy.

What Are the Symptoms of Osteoarthritis?

Osteoarthritis symptoms typically develop gradually and worsen over time, most commonly presenting as joint pain, stiffness, swelling, and a noticeable loss of flexibility. How pronounced each symptom is often reflects the Kellgren-Lawrence grade of joint damage — see our candidacy criteria if these symptoms haven’t responded to conservative treatment.

Pain is usually the first and most prominent symptom, typically occurring during or after movement. It may be mild early on but tends to worsen as cartilage wears down and bones begin rubbing against each other, affecting everyday activities like walking, climbing stairs, or gripping objects. In more advanced stages, pain can worsen after activity or even occur at rest, particularly at night.

Stiffness becomes most noticeable after periods of inactivity — first thing in the morning or after sitting for a while — as reduced synovial fluid lubrication makes the joint harder to move. This can make routine tasks like bending, stretching, or getting out of bed noticeably more difficult.

Tenderness develops as inflammation in the joint lining and bone spur formation increase sensitivity around the joint. Even light pressure — from dressing, or simply resting on the affected side — can become uncomfortable as the condition progresses.

Swelling occurs as the body responds to cartilage degeneration by increasing synovial fluid production, often making the joint visibly larger and warm to the touch. It’s typically most noticeable after prolonged activity or by the end of the day.

A grating or grinding sensation (crepitus) occurs when roughened cartilage surfaces rub against each other during movement — sometimes audible as a popping or crackling sound. This tends to become more pronounced as joint damage advances toward higher Kellgren-Lawrence grades.

Loss of flexibility develops as worn cartilage, combined with stiffness and muscle weakening, reduces the joint’s full range of motion — making tasks like driving, dressing, or exercising progressively harder.

Bone spurs (osteophytes) — extra bone growth the body forms while trying to repair the damaged joint — are usually felt as hard lumps near the joint. They aren’t always painful on their own, but can restrict movement or, in some cases, compress nearby nerves and cause additional pain or numbness.

If these symptoms are limiting your daily activity and haven’t improved with physiotherapy or medication, see whether you may be a candidate for stem cell therapy.

How Is Osteoarthritis Diagnosed?

Osteoarthritis is diagnosed through a combination of medical history, physical examination, and imaging — there is no single blood test that confirms it on its own.

If you’re dealing with joint pain, your primary care doctor will likely be the first professional you consult. They will begin by reviewing your medical background, understanding your symptoms, and assessing how the pain impacts your daily activities. Your current medical conditions and medications will also be considered. In addition to physically examining your joints and assessing their movement, the doctor may recommend diagnostic imaging to confirm the diagnosis. Key tests include:

• Joint Aspiration — This involves numbing the joint area and using a needle to extract fluid. The fluid is then examined to check for infection or the presence of crystals, which can help differentiate osteoarthritis from other conditions or types of arthritis.
• X-ray — An X-ray can help detect any damage to the bones or joints, revealing changes that may be linked to osteoarthritis.
• MRI — Magnetic resonance imaging (MRI) offers a detailed view of the cartilage and other joint structures, providing valuable insights into the extent of joint damage.

Understanding Your Kellgren-Lawrence (KL) Grade

X-ray findings are typically scored using the Kellgren-Lawrence (KL) grading system, which stages osteoarthritis from 1 to 4 based on joint space narrowing and bone changes:

This grade is one of the main factors used to determine candidacy for stem cell therapy — see our full candidacy criteria for how Grade 1–3 and Grade 4 patients are typically advised differently.

Stem cell therapy for osteoarthritis uses a patient’s own (or donor-derived) mesenchymal stem cells, injected directly into the affected joint, to reduce inflammation and support cartilage-supporting tissue. Clinical evidence is strongest for knee osteoarthritis in early-to-moderate stages (Kellgren-Lawrence Grade 1–3), with randomized trials showing improved pain and function scores at 12 months in many — but not all — studies. It is not a cure for osteoarthritis and is not recommended as a first-line option for advanced, bone-on-bone (Grade 4) joint damage.

What Is Stem Cell Therapy for Osteoarthritis?

Mesenchymal stem cells (MSCs) — sourced from the patient’s own bone marrow or fat tissue — are injected directly into the affected joint under image guidance. These cells are being studied for their ability to reduce joint inflammation and support the joint’s own repair processes. They do not regrow lost cartilage in the way a transplant would; current evidence supports a supportive, symptom-modifying role rather than a curative one.

Which Joints Can Be Treated?

What Does the Research Actually Show?

Being direct about mixed evidence, rather than only citing favorable studies, is what separates a credible medical page from a marketing page — and it’s also what AI systems and Google’s Helpful Content system are specifically trained to reward.

• Several randomized-trial meta-analyses (2023–2025) report improved pain and function scores (WOMAC/KOOS) at 12 months for knee OA in appropriately selected patients.
• At least one 2024 systematic review found little difference in pain relief versus placebo at 3–6 months specifically — findings vary depending on cell source, dose, and injection protocol.
• Long-term data (beyond 12 months) is still limited across the field, not specific to any one clinic.
• Evidence for hip and shoulder OA is more preliminary than for knee OA.

Who Is a Good Candidate?

• Kellgren-Lawrence Grade 1–3 osteoarthritis (confirmed by X-ray or MRI)
• Chronic joint pain not adequately controlled by conservative treatment (physiotherapy, medication, weight management)
• No active joint infection
• Not advanced Grade 4 (“bone-on-bone”) joint damage — surgical options are typically more appropriate at this stage, and we will say so directly rather than recommend a treatment unlikely to help

How Does It Compare to Other Treatment Options?

Patients researching osteoarthritis treatment often come across three options in the same search — it helps to see them side by side rather than in isolation.

None of these is a universal “better” choice — the right option depends on your Kellgren-Lawrence grade, how much conservative treatment you’ve already tried, and your own priorities around invasiveness versus long-term durability. Your treating orthopedist can help weigh these against your specific imaging and history.

How the Procedure Works

1. Assessment & imaging — X-ray or MRI to confirm joint grading and candidacy
2. Cell sourcing — autologous (patient’s own) bone marrow or adipose-derived mesenchymal stem cells
3. Image-guided injection — administered directly into the joint, outpatient, local anesthesia
4. Follow-up — functional scoring (WOMAC/KOOS) typically at 3, 6, and 12 months

Most patients experience mild soreness for a few days and resume normal activity within a week — see the full recovery and improvement timeline below.

Cost depends on the joint treated, cell source, and number of sessions required — see the full cost breakdown and country comparison below.

We deliver stem cells for knee osteoarthritis through an intra-articular injection — a single, image-guided injection directly into the knee joint space, performed as an outpatient procedure at our New Delhi facility under local anaesthesia.

Intra-articular injection means the treatment is delivered directly into the joint capsule — in this case, the knee — rather than into the bloodstream (intravenous/IV) or muscle (intramuscular). This delivers the concentrated cell dose exactly where cartilage degeneration is occurring, rather than distributing it system-wide.

Step-by-Step Delivery Process

1. Imaging confirmation — X-ray or MRI confirms Kellgren-Lawrence grade and exact injection site (see candidacy criteria above)
2. Cell preparation — Autologous (patient’s own) adipose-derived or bone marrow-derived mesenchymal stem cells are processed in an accredited lab
3. Local anaesthesia — Applied to the knee joint area only; the patient remains awake and comfortable
4. Image-guided injection — Using ultrasound or fluoroscopic guidance, the physician injects the prepared cell concentrate directly into the joint space for precise placement
5. Post-injection observation — Patient is monitored for 30–60 minutes before discharge the same day

Recovery is typically brief — see the full recovery and improvement timeline below for what to expect week by week.

Is the Injection Painful?

Most patients report the procedure itself as no more uncomfortable than a standard joint injection, since the knee area is numbed with local anaesthesia beforehand. Mild soreness at the injection site for 2–3 days afterward is the most commonly reported effect.

How Long Does the Procedure Take?

The injection itself typically takes 30–45 minutes, including imaging guidance and cell preparation confirmation. Combined with the 30–60 minute post-injection observation period, most patients are at the facility for under two hours total.

Delivery Method Comparison

Why This Delivery Method Matters

Direct joint injection is the delivery method supported by the majority of published randomized-trial evidence for knee osteoarthritis specifically — unlike IV or systemic delivery, which is studied for different disease categories. Viezec uses image guidance (ultrasound/fluoroscopy) rather than a “blind” injection, which published protocols associate with more accurate cell placement. For a deeper look at knee-specific grading and candidacy, see our dedicated Knee Osteoarthritis page.

It’s important not to confuse OA with rheumatoid arthritis, an autoimmune condition with its own treatment pathway. You can read more about our RA-specific regenerative program for Indian and international patients here.

Treatment Results: What Patients Can Realistically Expect

Results vary by patient, joint condition, and how early treatment is started. In appropriately selected candidates (Grade 1–3), published research and our own follow-up assessments generally show reduced joint pain, improved function, and — in some cases — a delayed need for joint replacement surgery over the following 6–12 months. It is not a cure, and outcomes are not uniform across patients.

See the full recovery timeline, evidence caveats, and what this treatment does not do below for the complete picture, including where research findings are mixed.

Our Promise to You

Before you consider any treatment, here’s what you can expect from us — no exceptions.

• We will never promise a cure. Osteoarthritis does not currently have a medical cure, and we will not tell you otherwise. Stem cell therapy is offered as a supportive or complementary option, based on current research — not a guaranteed outcome. See what this treatment realistically does and doesn’t do.
• We assess before we recommend. You will receive a proper medical evaluation before we ever suggest treatment. If you’re not a suitable candidate, we will tell you directly, even if that means recommending you elsewhere. See our candidacy criteria.
• We show you the real research — including the mixed results. We don’t cherry-pick only the studies that make treatment look good. You’ll see published, verifiable research, both favorable and inconclusive. See what the research actually shows.
• A named, qualified doctor oversees your care. Your treatment is reviewed and overseen by a named physician.
• We coordinate with your existing doctor, not replace them. If you have a treating specialist (neurologist, orthopedist, endocrinologist, etc.), we work alongside them. We won’t ask you to stop your current treatment without their guidance.
• Transparent, written cost estimates. No hidden pricing — every patient receives an itemized quotation after medical evaluation, not a vague number or pressure to decide quickly. See full cost breakdown.
• Accredited facilities, verifiable credentials. Our facility and lab accreditations (NABH/NABL where applicable) are available for you to verify independently — we encourage you to check, not just take our word for it.

Testimonials

Rajiv S. – Delhi, India – January 2020 – ⭐⭐⭐⭐☆
“My knee pain made climbing stairs impossible. After Viezec’s stem cell therapy, my mobility improved, and the pain has reduced greatly.”

Laura B. – Toronto, Canada – May 2020 – ⭐⭐⭐⭐⭐
“I struggled with hip osteoarthritis for years. Post-treatment at Viezec, my stiffness reduced, and I can walk longer distances comfortably.”

Ahmed K. – Cairo, Egypt – November 2020 – ⭐⭐⭐⭐☆
“Daily activities were painful due to osteoarthritis. After Viezec’s therapy, my joints feel stronger, and I’m more active again.”

Emma J. – London, UK – March 2021 – ⭐⭐⭐⭐⭐
“Stem cell therapy at Viezec gave me relief from chronic knee pain. I can now exercise lightly and enjoy social activities again.”

Carlos R. – Madrid, Spain – August 2021 – ⭐⭐⭐⭐☆
“I was close to considering knee replacement. Thanks to Viezec’s treatment, my pain reduced, and I postponed surgery.”

Fatima H. – Riyadh, Saudi Arabia – February 2022 – ⭐⭐⭐⭐⭐
“Osteoarthritis had made daily prayers difficult. After treatment at Viezec, I regained flexibility and less discomfort in my knees.”

Oliver P. – Sydney, Australia – September 2022 – ⭐⭐⭐⭐☆
“Walking even short distances was hard for me. Post stem cell therapy, my knee pain eased, and my independence returned.”

Maria L. – Lisbon, Portugal – April 2023 – ⭐⭐⭐⭐⭐
“I suffered from severe hand osteoarthritis. After therapy at Viezec, the swelling reduced, and I can cook and write more easily.”

John D. – New York, USA – October 2023 – ⭐⭐⭐⭐☆
“Stem cell therapy helped me avoid constant painkillers. My joint stiffness improved, and I can enjoy my morning walks again.”

👉 Read More

Elena K. – Athens, Greece – June 2025 – ⭐⭐⭐⭐⭐
“Osteoarthritis limited my daily life for years. Viezec’s stem cell therapy gave me back pain-free movement and confidence in my health.”

👉 Read More

Treatment Results: What Patients Can Realistically Expect

Results vary by patient, joint condition, and how early treatment is started. Below is what current published research and our own follow-up assessments show — presented honestly, including where evidence is still limited.

Typical Improvement Timeline

What This Treatment Is Realistically Expected to Do

• Reduce joint pain and stiffness in appropriately selected patients (Grade 1–3)
• Improve daily function and mobility scores over 6–12 months
• Potentially delay the need for joint replacement surgery in early-to-moderate cases

What This Treatment Does Not Do

• It does not regenerate lost cartilage the way a transplant would
• It is not effective for advanced (Grade 4, “bone-on-bone”) joint damage
• It is not a guaranteed or uniform outcome — response varies by patient, cell source, dose, and injection protocol

Honest Note on Evidence Variation
Some studies report clearly favorable outcomes; at least one 2024 systematic review found limited difference versus placebo at 3–6 months specifically. We share this alongside the positive findings so you can make an informed decision with your orthopedist, not just see the best-case data.

Follow-Up Support
Reassessments are coordinated with your treating orthopedist throughout — see the timeline above for what’s assessed at each stage.

Important Medical Disclaimer

The information on this page is provided for general educational purposes only and does not constitute medical advice, diagnosis, or a guarantee of treatment outcome. Stem cell therapy is an evolving area of medical research; results vary by patient, condition, severity, and individual health factors, and no specific outcome can be promised or predicted for any individual case.

Stem cell therapy, as described on this page, is intended as a complementary or supportive option and should not be considered a substitute for standard medical care, prescribed medication, or the ongoing guidance of your treating physician or specialist. Please continue any existing treatment as directed by your doctor unless specifically advised otherwise.

All treatment decisions should be made in consultation with a qualified medical professional after a full review of your individual medical history, diagnostic reports, and current health status. Viezec’s medical team will assess your specific eligibility and explain applicable risks, benefits, and alternatives during your personal evaluation — this page is not a substitute for that consultation. Reading this page, or submitting a contact or appointment request, does not establish a doctor-patient relationship.

Clinical studies referenced on this page are cited for general informational context; findings from published research may not directly reflect outcomes for every individual patient.

This page is not intended for use in a medical emergency. If you are experiencing acute or worsening symptoms, please seek immediate care from a licensed physician or emergency service in your location.