What is in a stem cell injection?
It depends on the product, and several contain very few stem cells or none.[1][2] The name covers at least seven different things.[1][3]
Bone marrow concentrate
Marrow drawn from your pelvis and spun down in the treatment room.[1]
Fat cells (SVF) or microfragmented fat
Fat taken by liposuction and processed the same day. Like marrow concentrate, it did not contain large numbers of mesenchymal stem cells when sequenced in the largest trial.[1]
Lab-grown or donor cord cells
Cells grown in a lab, frozen and thawed for injection. There is no harvest from your body.[1] About cord cells
Amniotic products, exosomes and PRP
Often sold under the same name. Three commercial amniotic fluid products tested in a lab contained no living stem cells.[2]
What to expect
The appointment
For your own cells, a harvest, then 30 to 120 minutes while the sample is processed, then the injection: about a morning.[4][5][1] Ultrasound guidance makes the injection more accurate and less painful.[6][7]
How much does a stem cell injection cost?
Prices depend on the product, how many sites are treated, and whether the harvest, imaging and follow-up are included. Our clinic profiles list what each package includes and leaves out. Most of these treatments are not covered by insurance.[11]
The injection carries its own risks
Apart from the product, the needle matters. Joint infection after any joint injection happens in roughly 1 in 1,000 people and can show up to 16 weeks later.[12][13] A needle into a spinal disc causes infection in about 1 in 250, and punctured discs wore faster over ten years.[14][15] Fat injected into the face has caused 61 published cases of a blocked artery, with permanent blindness and six deaths.[16]
Are stem cell injections approved?
Nothing a private clinic can inject is an approved stem cell product in the US or Malaysia.[17][18]
United States. A US appeals court ruled in 2024 that same-day fat-cell (SVF) injections are drugs that need FDA approval.[19]
Malaysia. Most stem cell products must be registered. Wellness and anti-ageing uses are not allowed without clinical proof.[18]
Specialists. The American College of Rheumatology recommends strongly against stem cell injections for knee and hip arthritis.[20]
Common questions
Does it hurt?
The injection is like any other joint injection. The harvest, if your own cells are used, hurts more.[21][1]
Is my own tissue automatically safe?
No. In one regulated trial, several fat and marrow samples failed a contamination test.[22]
Questions to ask a clinic
- What exactly is in the syringe? Ask for the product name.
- Is that a count of all cells, or of stem cells, and who measured it?
- Was the batch tested for sterility, and can I see the result?
- Will the injection be guided by ultrasound or X-ray?
- What do I do if the joint gets hot and painful three weeks later?
- Which controlled trial supports this for my condition?
Sources
22 references
- Mautner K, et al. Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nature Medicine, 2023. Link
- Panero AJ, et al. Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison. The American Journal of Sports Medicine, 2019. Link
- Murray IR, et al. Reporting Standards in Clinical Studies Evaluating Bone Marrow Aspirate Concentrate: A Systematic Review. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 2018. Link
- El-Khalawany M, et al. Efficacy of autologous stromal vascular fraction injection in the treatment of androgenic alopecia. Archives of Dermatological Research, 2023. Link
- Kuka G, et al. Cell Enriched Autologous Fat Grafts to Follicular Niche Improves Hair Regrowth in Early Androgenetic Alopecia. Aesthetic Surgery Journal, 2020. Link
- Wu T, et al. Ultrasound-guided versus landmark in knee arthrocentesis: A systematic review. Seminars in Arthritis and Rheumatism, 2016. Link
- Daley EL, et al. Improving injection accuracy of the elbow, knee, and shoulder: does injection site and imaging make a difference? A systematic review. The American Journal of Sports Medicine, 2011. Link
- Whittle SL, et al. Stem cell injections for osteoarthritis of the knee. The Cochrane Database of Systematic Reviews, 2025. Link
- Levi D, et al. Bone marrow concentrate intradiscal injection for chronic discogenic low back pain: A double-blind randomized sham-controlled trial. Interventional Pain Medicine, 2025. Link
- Riggle C, et al. Complications of Stem Cell-Based Injections for Knee Osteoarthritis: A Systematic Review. HSS journal, 2025. Link
- Manchikanti L, et al. Comprehensive Evidence-Based Guidelines for Regenerative Therapies in the Management of Chronic Low Back Pain: 2025 Update from the American Society Of Interventional Pain Physicians (ASIPP). Pain Physician, 2025. Link
- Petersen SK, et al. Low frequency of septic arthritis after arthrocentesis and intra-articular glucocorticoid injection. Scandinavian Journal of Rheumatology, 2019. Link
- Mueller MR, et al. Septic arthritis following intra-articular corticosteroid injections: a retrospective analysis. Archives of Orthopaedic and Trauma Surgery, 2026. Link
- Kapoor SG, et al. Systematic review of the incidence of discitis after cervical discography. The Spine Journal, 2010. Link
- Carragee EJ, et al. 2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study. Spine, 2009. Link
- Moellhoff N, et al. Arterial Embolism After Facial Fat Grafting: A Systematic Literature Review. Aesthetic Plastic Surgery, 2023. Link
- U.S. Food and Drug Administration. Approved Cellular and Gene Therapy Products. U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 2026. Link
- National Pharmaceutical Regulatory Agency, Ministry of Health Malaysia. Guidance Document and Guidelines for Registration of Cell and Gene Therapy Products (CGTPs) in Malaysia, Second Edition (September 2025). 2025. Link
- United States Court of Appeals for the Ninth Circuit. United States v. California Stem Cell Treatment Center, Inc., No. 22-56014, Opinion (filed September 27, 2024). 2024. Link
- American College of Rheumatology. 2026 Update of the American College of Rheumatology Recommendations for the Management of Osteoarthritis of the Knee, Hip, and Hand (summary). 2026. Link
- Oo WM, et al. Comparison of ultrasound guidance with landmark guidance for symptomatic benefits in knee, hip and hand osteoarthritis: Systematic review and meta-analysis of randomised controlled trials. Australasian Journal of Ultrasound in Medicine, 2024. Link
- Perkins KM, et al. Notes from the Field: Infections After Receipt of Bacterially Contaminated Umbilical Cord Blood-Derived Stem Cell Products for Other Than Hematopoietic or Immunologic Reconstitution - United States, 2018. MMWR. Morbidity and Mortality Weekly Report, 2018. Link




