Effectiveness of combined regenerative medicine and exercise therapy for patients with knee osteoarthritis: a scoping review.

Background: Regenerative therapies such as platelet-rich plasma (PRP) and stem cell treatments show promise for symptom relief in knee osteoarthritis (OA), but individual responses vary. Exercise therapy is a well-established intervention that enhances muscle strength and joint stability. Although both approaches are effective, their combined use remains underexplored. Notably, no systematic or scoping review has yet examined the specific types of regenerative medicine and exercise therapy used in combination, the outcome domains assessed (pain, function, structure, and quality of life), or the key evidence gaps. This scoping review aimed to examine these combinations, outcome domains, and gaps in the current evidence base. Methods: A literature search was conducted in MEDLINE, CENTRAL, and CINAHL using keywords including "knee osteoarthritis," "regenerative medicine," and "exercise therapy." Studies were included if they compared regenerative medicine alone to regenerative medicine combined with exercise therapy. Two reviewers independently extracted data on pain, physical function, and patient-reported outcomes across short-term (6-24 weeks) and long-term (up to 96 weeks) follow-up. Results: Three studies [two randomized controlled trials (RCTs), one non-RCT] were included. Sample sizes ranged from 17 to 32. Despite variations in PRP type (pure vs. leukocyte rich), and exercise regimen (home-based vs. supervised), all studies showed significant advantages in pain and function for the combined intervention group. Benefits emerged as early as 6 weeks and persisted up to 96 weeks. One study also noted structural changes via ultrasound. Conclusions: Combining regenerative medicine with exercise therapy significantly enhances pain relief and functional outcomes in knee OA patients.