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Managed with simple analgesics.","preparation":["Medical review and recent blood tests","Imaging of the target joint","Stop NSAIDs about 1 week before","Pause blood thinners if approved","Infection screening","Avoid smoking and alcohol beforehand","Hydrate and eat normally on the day"],"recovery_timeline":[{"phase":"Day 0-2","description":"Rest after harvest and injection; mild soreness and bruising are common.","restrictions":["Avoid heavy loading of treated area","No soaking harvest site in water"]},{"phase":"Week 1-2","description":"Soreness settles; gradual return to daily activity and light movement.","restrictions":["No strenuous exercise","Avoid NSAIDs unless approved"]},{"phase":"Week 2-6","description":"Progressive strengthening and guided physiotherapy; return to regular exercise.","restrictions":["Avoid high-impact sport until cleared"]},{"phase":"Month 3-6","description":"Gradual symptom improvement is assessed at review.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Return to ordinary daily function; physiotherapy may continue longer for joint conditions."},"result_longevity":"Benefit, if any, typically lasts 6-24 months and varies by condition. Repeat treatment may be considered.","revision_rate_pct":{"min":5,"max":20,"unit":"percent","qualifier":"Repeat injection within 2 years for insufficient benefit or recurrent symptoms; varies by joint and condition severity."},"scars":"No visible scar; a tiny puncture mark at the harvest and injection sites fades within days to weeks.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single same-day session; repeat injections are optional and not routine."},"stages":[{"code":"cell_harvest","label":"Harvest bone marrow or fat tissue","after":{"min":0,"max":0,"unit":"days","qualifier":"Start of the session."}},{"code":"cell_processing","label":"Concentrate or isolate the cells","after":{"min":0,"max":0,"unit":"days","qualifier":"Same day, about 1-2 hours after harvest."}},{"code":"cell_injection","label":"Inject cells into the target site","after":{"min":0,"max":0,"unit":"days","qualifier":"Same day after processing."}}],"qualifier":"Autologous harvest, processing and injection all occur in one visit."},"success":{"metric":null,"value":null,"unit":null,"horizon":null,"population":"Adults with knee osteoarthritis or tendon and cartilage degeneration","evidence_status":"not_proven"},"techniques":[{"name":"Bone marrow aspirate concentrate injection","suits_whom":"Adults with joint osteoarthritis or tendon problems.","recovery":"Mild harvest-site soreness for several days."},{"name":"Adipose-derived stem cell injection","suits_whom":"Adults with osteoarthritis; fat tissue is more abundant than marrow.","recovery":"Bruising at the liposuction site for 1-2 weeks."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Includes harvest, on-site processing and injection in one same-day session."},"initial_assessment_documents":["Medical history and current medication list","Recent blood test results","Infection screening results","Imaging of the target site"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single same-day autologous procedure with remote follow-up; one trip covers the standard protocol."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team treating you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Check how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check whether follow-up care is scheduled at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":403}},{"id":"C4","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Clinic advertisement offering a patient-funded clinical trial","scope":"procedure","source":{"url":"https://archive.cdc.gov/www_cdc_gov/hai/outbreaks/stem-cell-products.html","host":"archive.cdc.gov","quote":"Patients should always be wary if a clinic advertises a patient-funded clinical trial.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Joint becomes red, warm, or tender","urgency":"contact_clinic","general":false,"source":{"url":"https://www.aafp.org/afp/2002/1015/p1511.html","host":"aafp.org","quote":"If the joint becomes red, warm, or tender, or if you develop a fever in the first few days after the procedure, please call your doctor.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Needle site bleeds more than expected","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/22297-bone-marrow-aspiration","host":"my.clevelandclinic.org","quote":"The site bleeds more than you expect.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Fever in the first few days","urgency":"contact_clinic","general":true,"source":{"url":"https://www.aafp.org/afp/2002/1015/p1511.html","host":"aafp.org","quote":"If the joint becomes red, warm, or tender, or if you develop a fever in the first few days after the procedure, please call your doctor.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Tells home doctor the treatment given and discharge medicines","document":"discharge summary letter","source":{"url":"https://www.cornwallft.nhs.uk/going-home/","host":"cornwallft.nhs.uk","quote":"This is a letter giving details of your hospital treatment and discharge medications.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for copies of all prescriptions before you leave","document":"prescription 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treatments do not work","name":"Total knee replacement","source":{"url":"https://www.healthline.com/health/stem-cell-therapy-for-knees","host":"healthline.com","quote":"If these don't work or become ineffective, a total knee replacement surgery may be an option.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-11","next_check_at":"2027-11-11","version":1},"technique_details":{"status":"ok","items":[{"id":"bone-marrow-aspirate","name":"Bone marrow aspirate concentrate injection","how_it_works":{"text":"Cells extracted from bone marrow are concentrated into a solution","source":{"url":"https://my.clevelandclinic.org/health/procedures/bone-marrow-concentrate-bmc","host":"my.clevelandclinic.org","quote":"BMAC is a concentrated solution of cells and proteins extracted from bone 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