Exosome Therapy for Knees and Joints (EXOJOINTS)

Exosome therapy for knees and joints uses exosomes from mesenchymal stem cells, injected into or around the joint, to reduce inflammation and support the repair of cartilage, tendons and ligaments. It is used mainly for knee osteoarthritis, cartilage injuries and tendon or ligament problems, as the minimally invasive EXOJOINTS procedure.

Exosomes derived from mesenchymal stem cells (MSCs) have emerged as a therapeutic option for orthopedic conditions. These tiny extracellular vesicles contain signaling molecules including growth factors, cytokines, and microRNAs that promote tissue regeneration and reduce inflammation throughout the musculoskeletal system. This page is part of our guide to exosome therapy and covers exosomes treatment for knees and other joints: the conditions treated, how it works, who it suits, the procedure, sessions and cost.

Exosomes in orthopedics: conditions treated

Exosomes therapy for orthopedic treatments promotes tissue repair and regeneration in osteoarthritis, cartilage degeneration, tendon or ligament injuries, tendonitis, tendinopathy, bone fractures or non-unions, avascular necrosis, cartilage injuries, and conditions associated with inflammation, tissue damage, and loss of function.

Osteoarthritis

Patients with osteoarthritis experience cartilage degeneration, joint inflammation, and loss of function. MSC-derived exosomes promote cartilage regeneration, reduce chronic inflammation, and modulate the immune response, potentially slowing disease progression.

Tendon and ligament injuries

Patients with tendon or ligament injuries, such as tendinopathy, tendonitis, or partial tears, may find MSC-derived exosome treatment particularly helpful in promoting tissue repair, reducing inflammation, and accelerating the healing process.

Bone conditions

Patients with bone fractures or non-unions that are slow to heal may benefit from MSC-derived exosome treatment. The therapy promotes bone regeneration, enhances angiogenesis, and supports the overall healing process, including in avascular necrosis.

Cartilage injuries

Patients with cartilage injuries or defects, such as chondral lesions, may benefit from MSC-derived exosome treatment, as it promotes cartilage regeneration and repair. This is particularly valuable since cartilage has limited self-healing capacity.

Post-surgical recovery

Patients undergoing joint replacement surgery may find MSC-derived exosome treatment beneficial in promoting tissue repair around the implant, reducing post-operative inflammation, and potentially shortening the recovery period.

Exosome therapy for knees

Exosome therapy for knees is most often used for knee osteoarthritis, cartilage damage and the tendon problems around the knee. Exosomes are injected into the knee joint (intra-articular) to act on the cartilage and the joint lining, or around it (peri-articular) for tendons and ligaments such as the patellar tendon.

Knee osteoarthritis

In knee osteoarthritis, the cartilage that covers the ends of the bones thins, the joint lining becomes inflamed and the bone underneath reacts. Doctors grade it on X-ray, commonly with the Kellgren-Lawrence scale from 1 (doubtful) to 4 (severe). Exosomes target the inflammation and the cartilage-forming cells, which is why mild to moderate osteoarthritis is the usual indication; in severe, bone-on-bone disease the aim is mainly pain relief and function.

Cartilage injuries in the knee

Focal cartilage lesions from sport or trauma, and the joint after arthroscopy, are other knee uses. Exosomes promote chondrogenesis, the formation of new cartilage tissue, which the knee cannot achieve well on its own.

For knee treatment with living cells, see our page on stem cell therapy for knees and ORTHOSKILL, our osteoarticular regeneration treatment with your own stem cells.

Stem cell exosomes for joint pain

Stem cell exosomes relieve joint pain mainly by calming the inflammation inside the joint, while supporting the repair of the tissues that generate the pain. MSC-derived exosomes contain anti-inflammatory molecules, such as cytokines and microRNAs, and may have analgesic effects that come not only from reduced inflammation but also from the modulation of pain signaling pathways.

That makes them relevant for painful knees, hips, shoulders, ankles and elbows, for chronic tendon pain and for pain that persists after surgery. Pain and stiffness depend largely on inflammation, which can change sooner; structural repair, where it happens, is slower.

Exosome therapy advantages

Exosomes have the potential to promote bone regeneration and healing. Studies have shown that exosomes derived from bone marrow stem cells can stimulate bone formation and improve fracture healing in animal models.

Exosomes derived from MSCs have been shown to contain a variety of signaling molecules, such as growth factors and cytokines, that can promote tissue regeneration and reduce inflammation. These exosomes have been studied extensively in preclinical models of orthopedic conditions, such as osteoarthritis, tendinopathy, and bone fractures, with promising results.

Exosomes derived from MSCs have been shown to promote chondrogenesis and reduce inflammation, leading to improved joint function. In bone fractures, exosomes derived from MSCs have been shown to stimulate bone formation and improve fracture healing.

One of the advantages of using exosomes derived from MSCs for orthopedic treatments is that they can be administered in a minimally invasive manner, such as by injection, which can reduce the need for surgery and associated risks.

• Cartilage protection and regeneration: exosomes promote chondrogenesis and reduce inflammation in arthritic joints, improving joint function and potentially slowing progression.
• Bone regeneration: targeted delivery of growth factors and signaling molecules activates bone-forming pathways.
• Anti-inflammatory effect: cytokines and microRNAs reduce inflammation in damaged tissue, creating a better environment for healing.
• Several tissues at once: the signals act on bone, cartilage, tendons and ligaments.
• Faster recovery: angiogenesis, less inflammation and cellular repair can shorten recovery periods.
• Cell-free: no living cells are injected; exosomes are easy to store and carry a low risk of immune reactions.

Mode of action in orthopedic treatments

Orthopedic conditions involve the musculoskeletal system, such as bone, cartilage and tendon, and include injuries, degenerative diseases and chronic pain. The mode of action of MSC-derived exosomes in orthopedic treatments involves several mechanisms.

Anti-inflammatory effects

MSC-derived exosomes contain a variety of anti-inflammatory molecules, such as cytokines and microRNAs, which help reduce inflammation in damaged tissues and promote tissue repair.

Chondrogenic and osteogenic differentiation

MSC-derived exosomes can stimulate the differentiation of progenitor cells into chondrocytes (cartilage cells) and osteoblasts (bone cells), promoting the regeneration of cartilage and bone tissue. This is especially beneficial for conditions like osteoarthritis and fracture healing.

Extracellular matrix remodeling

MSC-derived exosomes can remodel the extracellular matrix of injured tissue, facilitating tissue repair and regeneration. They regulate the production and degradation of collagen, proteoglycans and other matrix components that are essential for structural integrity.

Immunomodulatory effects

MSC-derived exosomes can modulate the immune response, which may be beneficial in autoimmune-related orthopedic conditions. By balancing pro-inflammatory and anti-inflammatory signals, they create a better environment for healing.

Pain relief

MSC-derived exosomes may have analgesic effects, helping to reduce the pain associated with orthopedic conditions.

Indications for orthopedic treatments

Mesenchymal stem cell (MSC)-derived exosomes have shown potential in addressing various orthopedic conditions due to their regenerative, anti-inflammatory, and immunomodulatory properties. Ideal patients for MSC-derived exosome treatment in orthopedic applications include those who:

• suffer from osteoarthritis: patients experiencing pain, inflammation and joint degeneration may benefit, as the treatment can help promote cartilage regeneration, reduce inflammation and modulate the immune response, improving joint function without surgery;
• have tendon or ligament injuries such as tendonitis, tendinopathy or partial tears, especially athletes and active people who want to return to activity sooner;
• have fractures or non-unions that are slow to heal or not healing properly;
• are undergoing joint replacement surgery and want to support tissue repair and reduce post-operative inflammation;
• have avascular necrosis, where angiogenesis and bone regeneration may help preserve the joint and potentially delay the need for replacement;
• have cartilage injuries or defects such as chondral lesions.

While MSC-derived exosome treatment may be suitable for many patients with orthopedic conditions, the decision is made individually after a thorough evaluation by a qualified physician, who reviews imaging, symptoms, expectations and medical history.

Autologous exosomes and donor-derived exosomes

Autologous exosome therapy means exosomes made from the patient's own cells, while most exosome treatments, including EXOJOINTS, use exosomes from a tested bank of mesenchymal stem cells. Producing autologous exosomes requires harvesting your tissue, growing the cells in a laboratory and isolating the exosomes, which adds time and cost.

Exosomes have low immunogenicity, which is why exosomes from screened donor cells can be used without matching. Patients who prefer a treatment based entirely on their own cells can choose ORTHOSKILL, which uses autologous adipose-derived stem cells. Our comparison of exosomes vs stem cells explains the difference between the two approaches.

The EXOJOINTS procedure

The EXOJOINTS procedure is performed through precise intra-articular or peri-articular injections, delivering concentrated exosomes directly to the affected area. The treatment is minimally invasive, performed on an outpatient basis, and typically requires minimal downtime, allowing patients to return to daily activities quickly.

1. Assessment: a clinical examination and recent imaging, such as X-ray or MRI, confirm the diagnosis and its grade.
2. Preparation: the skin is disinfected and a local anaesthetic can be used.
3. Injection: the exosomes are injected into the joint or around the tendon or ligament, with ultrasound guidance where precision matters.
4. After the injection: a short rest, then home the same day with advice on activity and physiotherapy.

The exosomes are extracted from human mesenchymal stem cells and thoroughly tested for quality and quantity. Containing lipids, messenger RNA, cytokines and proteins, they are administered according to the specialist's recommendation, after a strict screening process that certifies sterility, safety for use and endotoxin levels.

Sessions, recovery and results timeline

The number of EXOJOINTS injections depends on the joint, the condition and its severity, so it is set at the assessment rather than fixed. A single joint with early changes and several joints with advanced osteoarthritis need very different plans, with reviews in between and occasional maintenance.

A temporary increase in joint discomfort can occur for a short time after the injection. Pain and stiffness, driven largely by inflammation, can change within weeks, while cartilage and tendon remodelling continue over months. Physiotherapy, weight management and strengthening of the muscles around the joint make the result more durable.

What affects the cost of exosome therapy for knees and joints

The cost depends on how many joints are treated, the number of injections, and the diagnostics and guidance needed.

• Number of joints or tendons treated.
• Number of sessions and maintenance.
• Imaging (X-ray, MRI) and ultrasound guidance.
• Physiotherapy and follow-up.

Our guide to regenerative treatment costs explains what a quote should include. Patients weighing platelet injections can read exosomes vs PRP, and active patients with sports injuries our page on exosome treatment for the body.

FAQ

Scientific content reviewed by the Bioscience Institute Scientific Board. · Last updated 2026-10-20

The information on this page is for general education and does not replace a consultation with a physician.