Research
We group the peer-reviewed literature by treatment and condition — including the rigorous trials where a therapy did not beat placebo. Every study below is real, cited, and links to PubMed.
Regenerative orthopedics doesn't mask pain — it targets the biology of healing. By concentrating your body's own platelets, growth factors and cells and delivering them precisely under ultrasound, the goal is to calm inflammation, stimulate repair, and restore function without surgery.
PRP and bone-marrow concentrate are autologous — drawn from you, concentrated, and returned to the injured tissue, releasing growth factors (PDGF, TGF-β, VEGF) that drive collagen synthesis and new blood-vessel formation.
Real-time ultrasound guidance places the biologic exactly at the lesion — the difference between a clinical-grade injection and a blind one.
The science is real but still maturing. Below we group the peer-reviewed evidence by treatment and condition — including the rigorous trials where a therapy did NOT beat placebo. We'd rather you see the whole picture.
Platelet-Rich Plasma (PRP)
Among the strongest evidence in regenerative orthopedics. Recent meta-analyses of double-blind RCTs favor PRP over hyaluronic acid for durable pain and function in knee OA.
Li YF et al. Arthroscopy · 2025
15 double-blind RCTs (1,632 patients): at 12 months PRP had significantly lower pain and total WOMAC scores than hyaluronic acid, both reaching clinical significance.
Wang C et al. Eur J Med Res · 2025
Pooled 28 RCTs (3,246 patients): PRP gave pain relief comparable to hyaluronic acid with superior functional improvement; best results from 3–5 injections at 7–14 day intervals.
Platelet-Rich Plasma (PRP)
Strong for chronic lateral epicondylitis (tennis elbow) in the long term; genuinely mixed for Achilles and patellar tendinopathy. We show both sides.
Mi B et al. Phys Sportsmed · 2017
8 RCTs (511 patients): corticosteroid won short-term, but PRP was superior for long-term pain relief at 6 months and 1 year.
Maroun R et al. Clin Shoulder Elb · 2025
26 RCTs (1,877 patients): steroids favored early, but long-term pain improvement favored PRP (MD −1.60, p<0.001).
de Vos RJ et al. JAMA · 2010
A single PRP injection was NOT superior to saline for midportion Achilles tendinopathy (VISA-A 21.7 vs 20.5 at 24 weeks). Included for honest balance.
Scott A et al. Am J Sports Med · 2019
With exercise rehab, a single PRP injection was no more effective than saline for patellar tendinopathy at any time point. Included for honest balance.
Bone Marrow Aspirate Concentrate (BMAC)
BMAC is consistently safe and produces real pain relief — but high-quality controlled trials show it often performs similarly to comparators rather than dramatically better. Honest framing matters here.
Shapiro SA et al. Am J Sports Med · 2017
Mayo Clinic trial: BMAC was safe and gave dramatic pain relief — but improvement did not differ significantly between BMAC and saline knees.
Boffa A et al. Knee Surg Sports Traumatol Arthrosc · 2022
Rizzoli Institute: BMAC matched hyaluronic acid overall, with higher pain improvement at 24 months (p=0.002) and more durable benefit in milder OA.
Han JH et al. Orthop J Sports Med · 2024
Across RCTs, BMAC improved clinical scores but showed no significant superiority over other intra-articular injections.
Adipose-Derived / Mesenchymal Stem Cells
Some of the most encouraging high-evidence regenerative data: Phase II–III placebo-controlled trials show adipose-derived MSCs improve knee OA pain and function, with MRI hints of disease modification.
Kim KI et al. Am J Sports Med · 2023
Adipose-derived MSCs significantly improved pain and function vs control at 6 months, with a favorable safety profile.
Lee WS et al. Stem Cells Transl Med · 2019
The adipose-MSC group showed significant WOMAC improvement at 6 months while controls showed no significant change.
Freitag J et al. Regen Med · 2019
Clinically significant pain and functional improvement at 12 months with MRI evidence suggesting possible disease modification; safe.
Shockwave Therapy (ESWT)
A mature, well-supported evidence base: meta-analyses and classic RCTs back shockwave for plantar fasciitis and calcific rotator-cuff tendinitis.
Lippi L et al. Eur J Phys Rehabil Med · 2024
Across 11 studies, ESWT was effective and tolerable for plantar fasciopathy, with significant pain reduction for both focal and radial ESWT.
Lou J et al. Am J Phys Med Rehabil · 2017
Pooling 9 RCTs, ESWT (without local anesthesia) significantly improved pain and functional success vs placebo.
Gerdesmeyer L et al. JAMA · 2003
n=144: both high- and low-energy ESWT improved shoulder scores vs sham at 6 months, with high-energy superior.
Brindisino F et al. Physiother Res Int · 2024
Across 21 RCTs, high-energy ESWT was clinically superior to low-energy for pain, function and calcification resorption.
Non-Surgical Spinal Decompression
Best understood as a useful adjunct to physical therapy: it adds meaningful pain and disability improvement, though it isn't proven to shrink herniations more than PT alone.
Amjad F et al. BMC Musculoskelet Disord · 2022
Adding spinal decompression to routine PT gave significantly greater improvement in pain, disability, range of motion and quality of life (all p<0.001).
Demirel A et al. J Back Musculoskelet Rehabil · 2017
Both groups improved; herniation-size reduction was greater with decompression but not statistically significant vs PT alone. A useful adjunct.
Electromagnetic Transduction Therapy (EMTT®)
Promising but early. EMTT has a genuinely thin evidence base — one recent double-blind placebo-controlled RCT and one small feasibility study. We present it as emerging, not established.
Hollander K et al. J Back Musculoskelet Rehabil · 2026
126 patients (knee OA, rotator-cuff enthesopathy, lumbar spondyloarthrosis): EMTT improved function and reduced pain vs sham at 6 weeks, persisting at 12 weeks.
Gerdesmeyer L et al. J Foot Ankle Surg · 2017
53 patients: the EMTT group had significantly improved pain vs controls at 12 weeks; authors call for larger trials.
Our physicians don't just apply the evidence — they help build it. Selected peer-reviewed work from the RegenCore team:
Everts PA, Malanga GA, Paul RV, Rothenberg JB, Stephens N, Mautner KR Regen Ther · 2019
Rhim HC, … Paul RV, … Tenforde AS Br J Sports Med · 2025
Sussman WI, Buford DA, Bowers RL, Paul RV, Latzka EW J Arthroplasty · 2025
Barrett I, Ramakrishnan A, Cheung E Orthop Clin North Am · 2019
Barrett IJ, Krych AJ, Pareek A, … Levy BA Knee Surg Sports Traumatol Arthrosc · 2018
Barrett I, King AH, Riester S, … Krych AJ Cartilage · 2016
Dr. Andrew Vargas (anesthesiology/interventional pain) is also published in the peer-reviewed literature (Transfusion, 2021, PMID 33846984). The 'SAFE BMAC consensus guidelines' referenced elsewhere could NOT be located in PubMed under a citable identifier — omitted to avoid citing an unverifiable publication.
Book a concierge evaluation in San Francisco or Palo Alto.
