Regenerative and Conventional Intra-Articular Therapies in Osteoarthritis: A Narrative Review with a Focus on Sports Medicine
DOI:
https://doi.org/10.12775/QS.2026.55.70920Keywords
osteoarthritis, intra-articular injections, sports medicine, platelet-rich plasma, hyaluronic acid, mesenchymal stem cells, regenerative medicine, physical activityAbstract
Background. Osteoarthritis (OA) is one of the leading causes of chronic pain and functional limitation worldwide and represents a significant challenge not only in the general population but also in physically active individuals, where joint integrity is essential for maintaining mobility and performance.
Aim. The aim of this study was to present current evidence regarding the efficacy and safety of conventional and modern intra-articular injections in the treatment of osteoarthritis, with particular emphasis on their relevance in sports medicine and physically active populations.
Materials and Methods. This study was designed as a structured narrative review synthesizing available data on intra-articular therapies, including glucocorticosteroids, hyaluronic acid, platelet-rich plasma (PRP), collagen, mesenchymal stem cells (MSC), and bone marrow aspirate concentrate (BMAC), as well as injection techniques and combined therapeutic approaches.
Results. Available evidence indicates that corticosteroids provide primarily short-term pain relief, whereas hyaluronic acid may offer moderate symptomatic improvement. Platelet-rich plasma demonstrates promising results in terms of longer-term pain reduction and functional improvement, which may be particularly relevant for maintaining physical activity levels. Cell-based therapies and collagen injections represent emerging approaches, although they require further standardization and high-quality clinical trials.
Conclusions. Modern intra-articular injections may constitute an important component of integrated osteoarthritis management, particularly in individuals aiming to maintain mobility and physical performance. These therapies may play a key role within personalized treatment strategies in sports medicine and rehabilitation.
References
Altman, R.D. & Bedi, A. (2015). Hyaluronic acid injections in osteoarthritis. Cartilage. https://doi.org/10.1177/1947603515588578
Andia, I. & Maffulli, N. (2013). Platelet-rich plasma for managing pain and inflammation. Expert Opinion on Biological Therapy, 13(5), 573–585. https://doi.org/10.1517/14712598.2013.774457
Anz, A.W. et al. (2020). PRP vs BMAC. Orthopaedic Journal of Sports Medicine.
Arden, N.K. et al. (2021). Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nature Reviews Rheumatology, 17, 59–66. https://doi.org/10.1038/s41584-020-00523-9
Bannuru, R.R. et al. (2015). Comparative effectiveness of pharmacologic interventions for knee osteoarthritis. Annals of Internal Medicine, 162(1), 46–54. https://doi.org/10.7326/M14-1231
Bannuru, R.R. et al. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage, 27(11), 1578–1589. https://doi.org/10.1016/j.joca.2019.06.011
Berkoff, D.J., Miller, L.E. & Block, J.E. (2012). Ultrasound-guided knee injections are more accurate. The American Journal of Sports Medicine, 40(9), 2005–2008. https://doi.org/10.1177/0363546512453299
Bowman, S. et al. (2018). Hyaluronic acid mechanisms. Clinical Medicine Insights: Arthritis.
Campbell, K.A. et al. (2015). Platelet-rich plasma in meniscus repair. Orthopaedic Journal of Sports Medicine. https://doi.org/10.1177/2325967115573298
Caplan, A.I. & Correa, D. (2011). MSC immunomodulatory mechanisms. Cell Stem Cell, 9(1), 11–15. https://doi.org/10.1016/j.stem.2011.06.012
Centeno, C.J. et al. (2015). BMAC therapy outcomes. Pain Physician.
Dai, W.L. et al. (2017). Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis. Arthroscopy, 33(3), 659–670. https://doi.org/10.1016/j.arthro.2016.09.024
Dohan Ehrenfest, D.M. et al. (2014). Classification of platelet concentrates. Trends in Biotechnology, 32(9), 469–478. https://doi.org/10.1016/j.tibtech.2014.04.006
Filardo, G. et al. (2011). Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy, 19(4), 528–535. https://doi.org/10.1007/s00167-010-1238-6
Finnoff, J.T. et al. (2010). Accuracy of ultrasound-guided injections. PM&R, 2(10), 957–963. https://doi.org/10.1016/j.pmrj.2010.06.014
Freitag, J. et al. (2016). Mesenchymal stem cell therapy. Regenerative Medicine. https://doi.org/10.2217/rme-2016-0046
Furuzawa-Carballeda, J. et al. (2012). Collagen therapy in osteoarthritis. Journal of Inflammation.
Hochberg, M.C. et al. (2012). American College of Rheumatology recommendations. Arthritis Care & Research.
Hunter, D.J. & Bierma-Zeinstra, S. (2019). Osteoarthritis. The Lancet, 393(10182), 1745–1759. https://doi.org/10.1016/S0140-6736(19)30417-9
Jevsevar, D.S. et al. (2013). AAOS guideline update. The Journal of Bone and Joint Surgery.
Kolasinski, S.L. et al. (2020). 2019 American College of Rheumatology/Arthritis Foundation guideline. Arthritis Care & Research, 72(2), 149–162. https://doi.org/10.1002/acr.2413
Kon, E. et al. (2013). Biological treatments for cartilage regeneration. The Journal of Knee Surgery.
Martel-Pelletier, J. et al. (2016). Osteoarthritis. Nature Reviews Disease Primers, 2, 16072. https://doi.org/10.1038/nrdp.2016.72
McAlindon, T.E. et al. (2017). Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain. JAMA, 317(19), 1967–1975. https://doi.org/10.1001/jama.2017.5283
Shen, L. et al. (2017). The temporal effect of PRP on pain. Arthroscopy. https://doi.org/10.1016/j.arthro.2016.12.019
Sibbitt, W.L. et al. (2009). Does ultrasound guidance improve outcomes. The Journal of Rheumatology, 36(9), 1892–1902. https://doi.org/10.3899/jrheum.090013
Silverwood, V. et al. (2015). Current evidence on risk factors for knee osteoarthritis. Osteoarthritis and Cartilage, 23(4), 507–515. https://doi.org/10.1016/j.joca.2014.11.019
Smith, J. & Finnoff, J.T. (2009). Sonographically guided intra-articular injections. Journal of Ultrasound in Medicine, 28(10), 1393–1401. https://doi.org/10.7863/jum.2009.28.10.1393
Wernecke, C., Braun, H.J. & Dragoo, J.L. (2015). The effect of intra-articular corticosteroids on articular cartilage. Orthopaedic Journal of Sports Medicine. https://doi.org/10.1177/2325967115581163
Xie, X. et al. (2014). Platelet-rich plasma for knee osteoarthritis. Arthroscopy. https://doi.org/10.1016/j.arthro.2014.05.007
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Copyright (c) 2026 Izabela Rafalska, Jakub Smagoń, Martyna Kaim, Melania Majewska, Natalia Piasecka, Wiktoria Siewiera, Joanna Bober, Natalia Kornacka, Krzysztof Bednarski, Magdalena Bochenek
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