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Biologic therapies offer a non-surgical option for patients suffering from knee pain or soft tissue injury. By targeting inflammation and encouraging tissue repair, these treatments help restore joint function and improve mobility.
This protocol outlines how to safely administer intra-articular (joint) and intramuscular (IM) biologics to treat common knee conditions such as osteoarthritis, ligament damage, and meniscal tears.

Best suited for patients who have:
Mild to moderate knee osteoarthritis
Meniscal damage, ligament sprains (ACL, MCL), or chronic tendinopathy
Active individuals or athletes looking to speed up recovery or avoid surgery
Contraindications:
Infections near the knee or systemic inflammation
Severe degenerative damage requiring joint replacement
Uncontrolled conditions like diabetes, clotting disorders, or autoimmune disease
Allergy risk to injectables, stem cell products, or anesthetics
Clinic Setup
Disinfect surfaces and instruments to maintain a sterile environment
Ensure all materials are within expiration and stored properly
Essential Equipment:
Biologic vials (stem cells, exosomes)
3–5 mL sterile syringes
Topical antiseptics (e.g., alcohol, chlorhexidine)
Ultrasound for guided injection
Local anesthetic if needed
Patient Prep
Informed consent: Clearly explain the procedure, risks, and recovery plan
Pain relief options: Offer topical or injectable anesthetic (allow 5–15 mins for effect)
Skin prep: Thoroughly clean the knee area to reduce infection risk
Types of Injection:
Intra-Articular: Direct injection into the joint to reduce pain and support cartilage repair
Intramuscular: For tendon or muscle injuries surrounding the knee (e.g., quads, patella)
Step-by-Step Protocol:
Use ultrasound to identify the target area
Draw 1–3 mL of biologic solution into a sterile syringe
For joint injections, use a medial or lateral approach under guidance
For muscular injections, target inflamed areas like the rectus femoris or lower quadriceps
Apply light pressure after the injection and monitor for any discomfort
Immediately After:
Limit strenuous movement or heavy impact for 1–2 days
Mild soreness or swelling is common and typically resolves quickly
Pain Management:
Use acetaminophen for discomfort
Avoid NSAIDs to protect the healing phase and maximize regenerative impact
First Visit:
Reassess in 2–4 weeks
Evaluate pain levels, joint mobility, and recovery progress
Decide if more sessions are needed based on outcomes
Long-Term Care:
Continue monitoring every few months
Additional injections can be spaced 4–6 weeks apart, depending on response
Adjust treatment as needed based on clinical evaluation
During the Procedure:
Observe the patient for 10–15 minutes after the injection
Watch for allergic responses or unexpected discomfort
Emergency Readiness:
Keep epinephrine and antihistamines available
Ensure the care team is trained for emergency response, even though incidents are rare
Preventing Infection:
Use aseptic technique at every stage
Do not reuse any equipment or open materials outside of a sterile zone
Keep detailed notes in the patient’s medical record, including:
Product type, dose, and batch number
Injection site and approach used
Patient response and aftercare instructions
Follow-up results and any adjustments to care plan
Biologic treatments for knee pain provide a powerful, non-invasive option for restoring mobility and improving quality of life. This step-by-step protocol helps clinicians deliver consistent, safe, and patient-centered care—especially for those looking to avoid surgery or extend the benefits of post-op recovery.
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