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MED 0001201549.  This website is for adult viewing (18+).  Please take time to read and understand the potential risks of surgery.

01Article · Research note

Non-operative options —
for arthritis-related joint pain.

This is a brief explanatory note on cell-based therapies — platelet-rich plasma, stromal vascular fraction and stem-cell preparations — that have been investigated as non-operative options for arthritis-related joint pain, tendon problems and frozen shoulder. The note is for general patient interest, not a treatment recommendation.

Written by Dr Kishen Nara · Reviewed for plain-language accuracy · Published 15 January 2024

02Why this note exists

A research interest —
alongside cosmetic care.

Dr Nara has a long-standing interest in non-surgical options for musculoskeletal problems. Before training in cosmetic medicine and surgery, his clinical work included extensive exposure to orthopaedic operations — joint replacements, elective surgery and trauma — and a year of dedicated training relating to musculoskeletal problems with a focus on frozen shoulder. He has also taught anatomy at Monash University.

Cell-based therapies use a patient's own cells, processed in different ways, and reintroduced at a site of injury or arthritis. The aim is to support the body's own healing rather than to replace tissue. Whether they help, and for whom, depends on the condition, the technique, and the individual patient.

More on the potential risks of cosmetic procedures is available on our risks page.

— Dr Kishen Nara, RevAesthetic.

Dr Kishen Nara, RevAesthetic
Dr Nara Melbourne rooms

03Three therapies — plain English

PRP, SVF —
and stem-cell preparations.

Platelet-rich plasma (PRP) is prepared by taking a blood sample, spinning it down, and concentrating the platelet fraction. Platelets carry growth factors that play a role in the early stages of healing. The concentrated preparation is injected at the affected site.

Stromal vascular fraction (SVF) is derived from a patient's own adipose tissue. After processing, a fraction containing a mixed population of cells is collected and may be reintroduced at the affected site.

Stem-cell preparations involve a wider category of cell-based products derived from a patient's own tissues. The terminology overlaps with the above, and how the cells are processed varies between protocols.

Each of these is investigational in many indications. Outcomes are variable and patient-specific. Where there is solid evidence in a given condition, that evidence guides the conversation; where there is not, the conversation is necessarily a cautious one.

04What they are considered for

The conditions —
and the limitations.

The two lists below outline conditions where cell-based therapies have been investigated as a non-operative option, alongside the general limitations that apply. Neither list is a recommendation — your individual circumstances will determine what, if any, of this is relevant.

Conditions sometimes considered

  • Osteoarthritis-related joint pain.
  • Tendon problems, including chronic tendinopathy.
  • Shoulder problems, including symptomatic adhesive capsulitis (frozen shoulder).
  • Some soft-tissue injuries where surgery is not yet indicated.

Limitations to be aware of

  • Not all patients are suitable. Strict exclusion criteria apply, depending on individual medical history.
  • These therapies are not a substitute for orthopaedic surgery when surgery is clinically indicated.
  • The evidence base continues to evolve — outcomes vary considerably between conditions and between patients.
  • A consultation with an orthopaedic specialist may be needed alongside, or instead of, this option.

05An orthopaedic opinion alongside

Specialist input —
where it is needed.

Cell-based therapies do not replace specialist orthopaedic care. For some patients, a consultant orthopaedic opinion is the right starting point — particularly where surgical options are clinically indicated, or where imaging suggests structural change that needs evaluation by a specialist. A second medical opinion is encouraged at any stage.

Outcomes from any non-surgical or surgical intervention vary depending on the individual — genetic factors, medical history, lifestyle and the specific condition all play a part. What is reasonable for one patient may not be reasonable for another. The role of the consultation is to think that through carefully, rather than to recommend a treatment by default.

06About the practitioner

Dr Kishen
Nara.

Dr Kishen Nara is a registered medical practitioner. He sees patients across Melbourne, Tasmania and Adelaide. The team at RevAesthetic includes practice manager Cate, Patient Liaison Jenny, and registered nurses, all involved in supporting your enquiry.

All assessments are conducted in line with Medical Board of Australia guidelines. A second medical opinion is encouraged at any stage.

  • MBBSBachelor of Medicine, Bachelor of Surgery — Monash University
  • FACCSM(Surg)Surgical Fellow, Australasian College of Cosmetic Surgery and Medicine
  • AHPRARegistered medical practitioner — General Registration MED0001201549
  • AnatomyAnatomy demonstrator, Monash University — musculoskeletal teaching

Read more about us

07Enquire

Begin a
conversation.

Consultations are conducted personally by Dr Nara across Melbourne, Tasmania and Adelaide. We respond within one business day. There is a written reflection period before any decision, and a second medical opinion is encouraged at any stage.

Prefer to write or call?

(03) 9720 6300

08Continue reading

More from
the journal.

Disclaimer: This article is a general explanatory note, not a treatment recommendation. Cell-based therapies are not appropriate for every patient and are not a substitute for specialist orthopaedic assessment where surgery is indicated. All medical procedures, including non-operative ones, carry inherent risks. We encourage you to seek a second opinion from a qualified medical professional before any procedure.

07 — Begin

Begin a conversation.

Contact us for more information, or to request a consultation.