In this conversation, we sat down with Dr. Julien Freitag, CEO and Chief Medical Officer of Magellan Stem Cells, to talk about how stem cell therapy for knee osteoarthritis actually works and where most clinics get it wrong.
Dr. Freitag is a musculoskeletal physician with 13 years of clinical research experience in this space. Below are the key points from the conversation, in plain language.
Do Stem Cells Actually Turn Into Cartilage in the Knee?
No, according to Dr Freitag and the latest research, stem cells are not turning into cartilage in the knee, despite what many clinics claim.
He explained that historically, doctors believed mesenchymal stem cells worked by becoming new cartilage. The more recent research shows that’s not what’s happening. The cells aren’t differentiating into cartilage cells in any meaningful way.
What they actually do is something different
What Do Mesenchymal Stem Cells Actually Do in the Knee Joint?
Mesenchymal stem cells reduce inflammation in the knee joint and signal the existing cartilage cells to produce more cartilage. According to Dr. Freitag, that’s the real mechanism, not the cells turning into new tissue themselves.
When the cells are injected, they read the local environment and look for what’s out of balance. If there’s too much inflammation, they release anti-inflammatory signals to calm it down.
If the existing cartilage cells are sluggish and not producing enough cartilage, the stem cells signal them to start working harder. Dr. Freitag described this role as a kind of “project manager” inside the joint.
So the regeneration that happens isn’t because the stem cells became cartilage. It’s because they told the cartilage cells already in the knee to do their job better.
What Results Has Magellan Seen?
Magellan has seen up to 85% success in patients with mild to moderate knee arthritis, dropping to 75% in severe cases. Those are Dr. Freitag’s numbers from their clinical research.
For pain specifically, patients with mild to moderate arthritis saw an average 70% improvement. Patients with severe arthritis saw around 50% improvement.
Dr. Freitag was clear that this isn’t a cure. It doesn’t grow a brand new knee. What it does is stabilise the arthritis, stop it progressing, and significantly reduce pain, which for a condition that normally gets worse every year is a meaningful result.
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How Long Do Magellan’s Stem Cell Treatments Last?
Magellan’s first patient is now nearly 13 years post-treatment and still significantly improved. That patient had end-stage grade 4 bone-on-bone arthritis before treatment.
Dr. Freitag described this as a single-injection treatment, not something patients need to come back for every year.
Some patients in their case series did re-present at around 8-10 years with some return of pain, and a small group have had repeat treatments.
But the durability of a single treatment is far longer than most people expect from any injection.
What’s still unknown is whether repeat treatments perform as well as the first one, that’s something the longer-term research will eventually answer.
Is It Better to Get Stem Cell Therapy Early?
Yes, getting stem cell therapy earlier appears to produce better results, especially after a knee injury. According to Dr. Freitag, this is where the most exciting evidence is.
He explained that some knee osteoarthritis is caused by a traumatic injury that progressively gets worse over the years. In Magellan’s research, patients treated in the early phase after a knee injury showed a strong regenerative response — and many didn’t go on to develop osteoarthritis at all.
His view is that preventative treatment, catching the joint early before it deteriorates, is probably where this field is heading.
Why Are Doctors Still Divided on Stem Cell Therapy for Knees?
Doctors are divided because the terminology is genuinely confusing, and a lot of treatments get lumped together under the same name. Dr. Freitag was direct about this.
He’s seen patients tell him they’ve had stem cell therapy when what they actually had was platelet-rich plasma (PRP), a different treatment with different expected outcomes. He also pointed out that there’s a strong commercial drive in some practices, where what’s being marketed doesn’t match what’s actually being delivered.
For a general doctor or surgeon trying to give patients advice, sifting through what’s accurate, what’s marketing, and what has real evidence is genuinely hard.
His suggestion to patients was simple, ask the right questions, and use platforms that help you understand what to ask.
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