Joint and Tendon Pain

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Biologic Therapy for Joint and Tendon Pain

Biologic therapy offers a minimally invasive, regenerative solution for joint and tendon pain caused by injury, inflammation, or degeneration. These treatments utilize chondrocyte-derived exosomes, rich in cartilage-specific growth factors and signaling molecules, to stimulate repair, reduce inflammation, and restore mobility. Unlike temporary symptom relief, these exosomes work at a cellular level, improving tissue function and slowing degeneration.

Step 1

Ideal Candidates

Best suited for patients who have:

Post-traumatic joint or tendon injuries
Chronic tendon pain or tendinopathy
Synovitis and inflammatory joint conditions
Athletes or active individuals looking to prevent surgical intervention

Contraindications:

Active joint or systemic infection
Recent corticosteroid or hyaluronic acid injection (<2 weeks)
Severe bone-on-bone degeneration without remaining cartilage
Autoimmune arthritis (RA, lupus) unless stable and physician-cleared
Allergy or hypersensitivity to any formulation ingredients

Step 2

Preparing for the Procedure

Clinic Setup

Performed in a sterile outpatient clinic
Conducted by a trained medical provider under ultrasound or fluoroscopic guidance

Patient Prep

Cleanse site with chlorhexidine or iodine solution
Use sterile gloves, drapes, and single-use syringes
Optional: Apply topical or injectable lidocaine for patient comfort
Aspirate excess joint fluid if effusion is present before injecting

Pre-Treatment Cautions

Avoid NSAIDs or corticosteroid injections 2 weeks before/after treatment to preserve biologic activity
Use MRI or ultrasound imaging to assess severity before initial treatment

Step 3

Injection Techniques

Exosome Type

Chondrocyte-derived exosomes or ECM allograft product (HCT/P compliant)

Delivery Method

Intra-articular injection is the standard for joint delivery
Injection depth varies by joint (synovial penetration is required)

Dosage & Frequency

2.0–4.0 mL per joint, depending on size/severity
- Initial series: 2–3 injections, spaced 4–6 weeks apart
- Maintenance: Every 4–6 months, based on clinical response and imaging

Technique:

Locate injection site via ultrasound or anatomical landmarks
Insert needle into synovial space using sterile technique
Inject slowly and evenly
Apply light pressure and observe the patient for immediate effects

Step 4

Aftercare & Monitoring

Immediate Guidelines

Mild soreness or pressure in the joint is normal and resolves within 48 hours
Apply ice packs (15 minutes, 2–3x/day) if needed
Avoid high-impact activity or heavy loading for 48–72 hours
Encourage gentle movement and hydration to support healing

Medication Guidelines

Use acetaminophen for discomfort
Avoid NSAIDs and corticosteroids for 48–72 hours post-injection to preserve cell signaling

Step 5

Safety Protocols

Post-Treatment Monitoring

Observe patient for 10–15 minutes for allergic reaction or discomfort
- Document:
  - Pain score
  - Range of motion (ROM)
  - Injection site
  - Lot number of the biologic product used

Emergency Preparedness

Keep the following on hand:
- Epinephrine auto-injector
- Antihistamines (oral or injectable)
- Injectable corticosteroids (e.g., dexamethasone)
- Pulse oximeter, oxygen, and BP cuff

Aseptic Protocol

Use strict sterile handling throughout the procedure
Do not mix exosomes with other medications unless clinically justified

Step 6

Ongoing Care

First Follow-Up

Re-evaluate at 4–6 weeks post-treatment
Assess improvements in:
- Pain reduction
- Swelling
- Joint mobility or flexibility

Maintenance Plan

Additional injections as needed every 4–6 months
Use imaging (MRI or ultrasound) to monitor cartilage preservation and tissue repair

Step 7

Documentation & Tracking

Procedure Records Should Include:

Biologic product (name, lot number, expiration)
Volume and delivery method
Injection site(s) and anatomical notes
Patient’s pre- and post-injection condition
Follow-up plan and any reported side effects

Summary

Regenerative biologic therapy using joint-specific exosomes offers a promising alternative to invasive procedures and long-term medication use for joint and tendon conditions. This protocol enables targeted repair, reduced inflammation, and improved mobility with minimal downtime. When administered in a structured clinical setting, biologics offer a safe, patient-centric solution for pain relief and long-term joint health.