A shift is happening in orthopedic care—one that’s backed by real data.
A 2025 systematic review of more than 75,000 patients found that Platelet-Rich Plasma (PRP) now surpasses cortisone in the number of published clinical studies for knee osteoarthritis. The same study highlighted a rapid increase in research focused on orthobiologics, including PRP and cell-based therapies, urging updated clinical guidelines to reflect this trend.
Side Note: Clinical guidelines are like a handbook for doctors and other healthcare professionals. They are essentially systematically developed recommendations, based on the best available scientific evidence, to help practitioners and patients make informed decisions about appropriate healthcare for specific clinical circumstances.
So what does this mean for patients?
For decades, cortisone injections have been a go-to treatment for joint and tendon pain. They’re fast, familiar, and often covered by insurance. But with growing research behind regenerative alternatives—and concerns about the long-term risks of cortisone—it’s time to ask:
Are we overusing cortisone?
Cortisone: Quick Relief, Long-Term Concerns
Cortisone is a steroid medication designed to reduce inflammation. When injected into painful joints or soft tissue, it can provide rapid relief. But here’s what most patients aren’t told:
- Repeated cortisone use can weaken cartilage, tendons, and ligaments over time
- It may temporarily mask pain without addressing the underlying cause
- In some cases, it can even accelerate joint degeneration
A 2019 review published in Radiology found that repeated corticosteroid injections were associated with worsening joint damage in the hips and knees—especially when used without clear clinical indications.
So while cortisone may still have a place in orthopedic care, particularly for short-term inflammation, it’s not always the best long-term strategy.
Enter Regenerative Orthopedics
At New Regeneration Orthopedics, we focus on non-surgical, regenerative options like Platelet-Rich Plasma (PRP) and bone marrow concentrate (which contains stem cells). These procedures are designed to support the body’s own healing process—rather than just dulling symptoms.
And the research is backing it up.
A 2025 systematic review published in Expert Opinion on Biological Therapy analyzed over 75,000 patients across 766 studies. The review found that PRP has now surpassed cortisone (CS) in the number of published studies—a clear reflection of the shift in focus from temporary symptom relief to long-term pain mitigation.
While hyaluronic acid (HA) still has the largest volume of evidence, the fastest-growing body of research now supports PRP and cell-based therapies, urging updates in clinical guidelines to reflect this momentum.
How Do These Treatments Compare?
When Should You Consider a Regenerative Option?
If you’ve had more than one cortisone injection—or are being told to come back every few months—it may be time to explore a more sustainable alternative. Regenerative procedures may be appropriate if:
- Your joint pain is recurring or worsening
- For example: Knee, shoulder, or hip arthritis.
- You want to avoid surgery or long-term medication use
- For example: Knee replacement surgery, shoulder replacement surgery, or hip replacement.
- You’re seeking an option that treats the root cause of the pain, not just the symptoms.
Why Choose New Regeneration Orthopedics?
- We use advanced imaging (ultrasound and fluoroscopy) to ensure cells are delivered precisely where needed.
- We follow lab protocols that increase the concentration of platelets and bone marrow concentrate, where stem cells are found, for optimal effect
- Our physicians, with over 30 years of combined experience, instruct other doctors nationwide in orthobiologic procedures through the Regenexx network, facilitated by the Interventional Orthobiologic Foundation.
- We track real patient outcomes through the world’s largest orthopedic stem cell registry
The Takeaway?
Cortisone has some select utilizations—but relying on it repeatedly can delay real healing and lead to further joint damage. Today’s research reveals that regenerative alternatives, such as PRP and bone marrow concentrate, are not just promising—they are proven, peer-reviewed, and evidence-backed.
Let’s talk about your options.
If you’re dealing with joint pain or exploring alternatives to cortisone, schedule a consultation today. Our team is here to help you recover with precision and confidence.
