Bone on Bone – Grade 4 Osteoarthritis – How does a Biological Treatment help?

April 25,2018

Macquarie Stem Cells has provided this information to educate the public based on peer reviewed, published scientific and medical documents. We don’t aim to encourage consumers to seek out such treatments prior to an assessment by a health professional to determine your suitability for treatment. This article is written based on multiple publications. We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, this is discussed in ‘supporting information>other-options’  page on our website

Biological Treatment – What if your joint is “Bone on Bone”?

Osteoarthritis is a very complex condition, many people assume cartilage is everything but this is wrong. Your pain starts due to loss of cartilage, however it continues to be a problem due to inflammation. Inflammation is destructive to all of the tissues in your joint.  Let’s look in detail below.

  • The cartilage (cushioning) in between the bones starts to wear away, cartilage is mainly avascular, meaning it has no blood supply. Without blood supply, repairs are just not possible. Since your cartilage can’t repair it self, this will trigger the inflammatory process, causing pain in your joints.
  • Ongoing or “chronic” inflammation damages surrounding tissues and structures of the joint.
  • Blood vessels inside the joints will become inflamed, blood carries nutrients. When the vessels are inflamed, delivery of nutrients become very poor. Overall health of the joint will decrease dramatically, continuing the domino effect.
  • Synovial membrane & bursal sacks become inflamed, then damaged over time.
  • When the synovial membrane becomes inflamed, it is not able to produce good quality lubrication. This will lead to further aggravation. (similar to an engine running without any oil)
  • Pain restricts movement, inflammation and swelling causes stiffness.
  • Restricted movement means the muscles and tendons supporting your joint become weaker and lose their flexibility
  • Many people with osteoarthritis will develop tendonitis (inflamed and painful tendons).
  • The nerve endings around the bone and general joint structure will become inflamed. This is what causes your night pains or resting pain.
  • Your body may try to repair the areas where cartilage has been lost, it will fail. This can cause small bony formations known as osteophytes. These osteophytes can cause severe pain.
  • Ongoing impact on your bones may cause bone oedema (swelling). Weight bearing on bone oedema will cause significant pain.
  • The lack of cartilage and ongoing movement in your joint allows the bones to rub against each other. This leads to bone sclerosis (hardening) of the bone.
  • Over time, the nerve endings to the sclerosed bones will lose their sensation. (this is not always bad)
  • The lack of movement along with the ongoing  wear and tear of the joint will push you to a point where you have no choice but to replace your joints….. OR PERHAPS NOT?

(Netzer et al., 2016) (Finnilä et al., 2016) (Michalek etal,. 2015) (Hayes et al., 2005) (Cassar-Pullicino, Darby and Davies, 2004) (van Ochten et al., 2014) (Li et al., 2013)


Your body has the potential to heal it self, sometimes it just needs guidance.


We can clearly see inflammation is the root cause of your problems, if we could resolve the inflammation and reinstate a healthy blood vessels, your joints would go into a state where repairs can be carried out.


  • We can use your body to target and fight off the inflammation that is causing you pain.
  • Your blood vessels, no longer inflamed. Nutrient delivery resumes as it always should have.
  • Your body makes lubrication for your joints (synovial fluid), when the inflammation is reduced it can continue making good lubrication inside your joints.
    Therefore, allowing free flowing movement within the joint.
  • Nerve pain, the pain that is keeping you awake at night. This can be taken care of, it’s root cause….? Inflammation of the nerves.
    • Don’t forget, sensations such as burning, tingling and numbness are types of nerve pain.
  • Bone oedema will resolve by it self, it does take a very long time. We can speed up this process significantly.
  • When the bone becomes sclerosed it becomes very hard and smooth, rather like marble. Since your synovial fluid is functioning properly, you will have slippery movement just as a marble floor would if it were wet. This is how your bone are able to ‘glide’ in conjunction as opposed to ‘grind’.


Previous literature along with our own experience from patients indicate, you may not need cartilage to have comfort and eliminate pain from your joints.

We have seen many patients over the past 9 years who are completely bone on bone to begin with and they remain bone on bone many years after the treatment BUT they have been able to get back to work along with their favourite activities with minimal to no pain.

Though this is a very hard concept to grasp, it will eventually become a part of common medical knowledge. We aim to make Biological Treatments the step prior to joint replacement.

(Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) , (Michalek, 2015) (Matsumoto et al., 2009) (Gibbs et al., 2015) (Freitag et al., 2016) (Paz Rodriguez et al., 2012) (Chang et al., 2016)


As your inflammation reduces, naturally you will start moving as normal. You may notice your muscles are weaker than usual, but this will step up and gain strength very quickly since muscles have very good blood supply. However, they gain strength too quickly and your tendons will not keep up. You will notice this when you feel your pain “shifts”.

  • At this stage, you may develop tendonitis, this is not a side effect of the treatment. It is simply your joint trying to get back to normal but it is encountering “growing pains”.

This occurs because your tendons have a very poor blood supply, blood is the key here. Tendonitis will pass naturally, but it will take a very long time. In some cases up to 2 years. You must continue with consistent physiotherapy to speed up this process.

Don’t forget, we are here to assist. We have other treatments available to speed up and resolve tendonitis quickly.

(Rohban and Pieber, 2017) (Fu et al., 2017) (Lauvrud et al., 2016) (Nguyen et al., 2016) (Chen et al., 2016)(Zachar, Bačenková and Rosocha, 2016)


REF: All references can be found through the following link. Click here.

You can read more about OSTEOARTHRITIS here & TREATING TEARS here.

To find out more please feel free to contact us!

Tags: Macquarie Stem Cells, Dr. Bright, Osteoarthritis Treatment, Dr. Ralph Bright, Biological Therapy, Biological Treatment, Biological methods to treat Arthritis, bone on bone knee, hip, shoulder


Remember, any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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