Regenexx is a set of injection-based orthopedic procedures that use your own blood platelets or bone marrow cells to treat joint pain, tendon injuries, and degenerative conditions. Instead of surgery, a physician draws biological material from your body, concentrates it, and injects it precisely into the damaged area using imaging guidance. The procedures are done in an outpatient setting without general anesthesia, typically in a single visit or a short series of visits.
How the Procedures Work
Regenexx procedures center on two types of injections. The first uses platelet-rich plasma (PRP), which is made by drawing your blood, spinning it in a centrifuge to concentrate the platelets, and injecting that concentrate into the injured tissue. Platelets contain growth factors that play a role in tissue repair and inflammation control.
The second type uses bone marrow concentrate (BMC). A physician extracts a small amount of bone marrow, usually from the back of the hip bone, and processes it to isolate stem cells and other regenerative components. This concentrate is then injected into the target area. BMC procedures are generally reserved for more significant damage, like moderate arthritis or larger tendon and ligament tears, because the cell concentrate is more potent than PRP alone.
Both injection types are placed using real-time imaging, either ultrasound or fluoroscopy (a type of live X-ray). This precision matters because the goal is to deliver the concentrated cells directly to the specific site of damage rather than flooding the general area.
Conditions and Joints Treated
Regenexx procedures are used across a broad range of musculoskeletal problems. The most common involve the knee (osteoarthritis, meniscus tears, ACL injuries, bone marrow lesions), hip (osteoarthritis, labrum tears, tendon tears), and shoulder (rotator cuff tears, labrum tears, osteoarthritis).
Spine conditions are also treated, including bulging and herniated discs, spinal stenosis, and persistent pain after back surgery. Smaller joints get attention too: carpal tunnel and thumb arthritis in the hand, tennis and golf elbow, ankle ligament and tendon tears, and even TMJ syndrome in the jaw. The underlying principle is the same regardless of location. Concentrated biological material is placed at the site of damage to support the body’s repair processes.
Not every patient is a good candidate. Severity matters. For something like a meniscus tear, physicians use grading systems that account for how deep the tear is, where it’s located, and how much it affects knee stability. Tears in areas with good blood supply (the outer “red zone” of the meniscus) have better healing potential than tears in the inner “white zone,” which has almost no blood flow. The same logic applies to other joints: the extent of degeneration, location of damage, and your overall health all factor into whether the procedure is likely to help.
What the Experience Looks Like
Because these are injection-based procedures, the experience is fundamentally different from surgery. There’s no hospital stay, no general anesthesia, and no large incisions. A typical appointment involves the blood draw or bone marrow aspiration, processing of the sample (which takes some time while you wait), and the guided injection itself. You go home the same day.
Recovery varies depending on which joint is treated and how severe the condition is. Most patients experience some soreness and swelling at the injection site for several days. Activity restrictions are usually lighter than after surgery, though physicians typically recommend avoiding high-impact exercise for several weeks while the injected cells do their work. Some conditions require more than one injection session spaced weeks apart.
Safety Profile
A large safety study tracked 2,372 patients across 3,012 procedures. A total of 325 adverse events were reported. The most common issues were post-procedure pain (affecting about 3.9% of patients) and pain from ongoing degenerative joint disease (3.8%). Because the injections use your own biological material, the risk of immune rejection or allergic reaction is essentially zero. Infection is possible with any injection but is rare when performed under sterile, image-guided conditions.
Regulatory Status
Regenexx has a complicated history with the FDA. In 2008, the FDA asserted that expanded (lab-cultured) stem cells qualified as a drug product, which triggered a legal dispute with the company then known as Regenerative Sciences. The core question was whether a physician taking a patient’s own cells, processing them, and returning them to the same patient constituted a medical procedure or drug manufacturing.
As a result of this regulatory pressure, Regenexx procedures in the United States now use same-day processing of bone marrow concentrate and PRP, which falls under different regulatory rules than lab-expanded cells. The company operates as a licensing network: physicians who perform these procedures are independent practitioners who have licensed Regenexx’s protocols and intellectual property rather than employees of a single medical practice.
Cost and Insurance Coverage
Regenexx procedures are often not covered by traditional health insurance, which means many patients pay out of pocket. Costs vary widely depending on the joint, the type of injection (PRP is generally less expensive than BMC), and geographic location, but most patients should expect to spend several thousand dollars per treatment area.
There is a corporate program designed for self-funded employer health plans. Regenexx markets this to employers as a way to cut musculoskeletal spending by 50% or more compared to surgical alternatives, claiming savings of up to 70% versus surgery. For employees enrolled in these plans, the procedure may be covered as a benefit. If you’re considering Regenexx, checking whether your employer offers this type of program is worth doing before assuming you’ll pay entirely out of pocket.
How It Compares to Surgery
The core appeal of Regenexx is avoiding the risks, downtime, and recovery burden of orthopedic surgery. A knee replacement, for example, involves months of rehabilitation and carries risks of blood clots, infection, and implant failure. A Regenexx injection for knee osteoarthritis involves days of soreness and weeks of modified activity.
The tradeoff is certainty. Joint replacement has decades of outcome data and works reliably for severe arthritis. Regenerative injection therapies are newer, and results vary more from patient to patient. People with mild to moderate degeneration tend to respond better than those with bone-on-bone arthritis or severely torn structures. For many patients, Regenexx works best as an option to try before committing to surgery, not as a replacement for it when surgery is clearly indicated.