By Vivonyx · Last reviewed: October 2026
Hip arthritis can make walking and stairs hard work. If you've been reading about stem cell injections for the hip, you've probably landed on one big question: can stem cells help hip arthritis?
This article walks through what the human hip studies actually tested and found. It's education, not medical advice, and it isn't a recommendation for or against anything.
Hip osteoarthritis in one minute
Osteoarthritis (OA) is the most common joint disorder [1]. Cartilage, the firm, rubbery tissue that cushions the ends of bones, breaks down and wears away, which often causes pain, swelling, and stiffness [1]. Extra body weight raises the risk of OA in the hip, and old joint injuries can lead to it later in life [1].
Exercise, medicines, and steroid injections can ease symptoms, and hip replacement is an option when damage is severe [1]. Stem cell research asks whether cells could add something: ease pain for longer, or help protect the joint.
What "stem cells" means in hip studies
The phrase covers several different things [2]:
Lab-grown (culture-expanded) MSCs. Mesenchymal stromal cells are taken from a person's bone marrow or fat, then grown in a lab to increase their number.
Bone marrow concentrate. Marrow is drawn from the pelvic bone and concentrated the same day.
Fat-tissue preparations. These include stromal vascular fraction and micro-fragmented fat, processed the same day.
These products contain very different numbers and kinds of cells, and some studies combined them with PRP [2]. Our science page explains what MSCs are, and Wharton's Jelly vs. Bone Marrow Stem Cells compares the main sources.
Most hip studies inject cells into the joint itself. A few instead inject bone marrow concentrate into the bone of the hip, just under the cartilage [8].
Two ways cells have been studied for hip osteoarthritis. Educational summary of the sources cited in this article.
Injected into the joint: what the studies found
The biggest issue is simple to state: randomized controlled trials of stem cells for hip arthritis are scarce. Most studies followed one group of people before and after an injection, with nothing to compare against.
A 2026 review found 9 studies with 307 people [2]. In the groups that reported it, average pain scores fell from 6.7 to 3.7. But the authors stress these were before-and-after changes, not comparisons with another treatment, and that small samples, mixed products, and mostly uncontrolled designs "preclude conclusions" about whether the cells work [2].
A 2024 review of 10 studies (316 people) reported better pain and function with few reported side effects, while noting limited high-quality studies and inconsistent measures [3].
A pooled analysis of bone marrow injections found lower pain scores at 3, 6, and 12 months, but it couldn't include a single randomized trial [5].
A review limited to bone marrow MSCs found just 7 studies with 72 people in total, all using "low-dose" injections, so it couldn't tell whether dose mattered [4].
Individual studies are small. In one, 10 people received three weekly injections of lab-grown bone marrow MSCs; hip scores improved, and X-rays looked unchanged in 9 of 10 [6]. In another, 55 people who got a micro-fragmented fat injection were followed for about three years: 28 needed no further treatment, 10 had another injection, and 17 had a hip replacement, on average about 16 months after the injection [7].
Why does a comparison group matter? Hip pain can rise and fall on its own, and many things besides the cells can shape how people feel after a procedure. Without a control group, a study can't separate those effects from the cells [2].
Injected into the bone
A 2026 study compared 217 hips that got bone marrow concentrate injected into the femoral head (the ball of the hip joint) with 217 matched hips that got conservative care [8]. By 15 years, 16.1% of the cell group went on to hip replacement, versus 40.1% of the comparison group [8].
That's a large gap, but the study wasn't randomized, so the groups may have differed in ways matching didn't capture. The authors reported professional and financial ties to a company that develops orthobiologic technologies [8], and a published letter has since addressed how the results should be interpreted [9].
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What guidelines and other injections show
A 2023 review of hip and knee OA guidelines found that the higher-quality guidelines consistently recommended against stem cell injections for the hip and knee [10]. They consistently favored education, exercise, and weight management [10].
PRP and hyaluronic acid have been studied more than cells. A 2025 review of 36 hip injection studies counted 21 on hyaluronic acid, 11 on PRP, and only 8 on cell-based products, and just 8 of the 36 studies were randomized [11]. Our knee article compares stem cells and PRP in more depth.
A different hip problem: osteonecrosis
Osteonecrosis is bone death caused by poor blood supply, and the hip is one of the most common places it happens [12]. One surgical option is core decompression, which removes part of the inside of the bone [12]. Here, randomized trials of adding bone marrow cells do exist, with mixed results.
In a 10-year randomized trial, hips that also received bone marrow cells went longer on average before worsening or needing replacement (about 102 vs. 78 months) [14]. In a double-blind randomized trial of more advanced disease, after the bone had begun to fracture, adding bone marrow concentrate made no difference: 15 of 23 hips in each group needed replacement [13]. Osteonecrosis is a different condition, so these results don't carry over to osteoarthritis.
FDA status and new trials
The FDA says regenerative medicine therapies have not been approved for any orthopedic condition, including osteoarthritis and hip pain [15][16]. The only FDA-approved stem cell products are blood-forming stem cells from umbilical cord blood, approved for certain blood disorders [16]. The FDA has also received reports of blindness, tumor formation, and infections linked to unapproved products [15]. Our guide Is Stem Cell Therapy FDA Approved? explains what approval means.
A ClinicalTrials.gov search for hip osteoarthritis and stem cells returns about a dozen listings, not all of them specific to hip OA [17]. One example is a small U.S. phase 1 study that randomly assigned 24 people with painful hip OA to one or two injections of lab-grown, fat-derived MSCs, with safety as its main outcome [18]. A listing doesn't, by itself, mean a product is approved or legally marketed [15].
What we still don't know
Whether cells beat a placebo or standard injection. Large randomized trials are missing.
Which product, dose, or delivery works best, into the joint or into the bone. Products vary widely [2][4].
Whether any benefit lasts or changes the joint itself [2].
Long-term safety. Serious problems were uncommon, but reporting was incomplete [2].
Frequently asked questions
Can stem cells help hip arthritis? Studies have reported less pain and better function after injections, but most had no comparison group, so it's unclear how much of that came from the cells [2][5].
Are there randomized trials of stem cells for hip osteoarthritis? Very few. One pooled analysis couldn't find any to include, and a 2026 review found mostly uncontrolled studies [2][5].
What kinds of cells are used? Lab-grown MSCs, bone marrow concentrate, and same-day fat-tissue preparations, sometimes combined with PRP. These are different products [2].
Do medical guidelines recommend stem cell injections for hip arthritis? No. Higher-quality guidelines consistently recommend against stem cell injections for hip and knee osteoarthritis [10].
Is stem cell therapy FDA-approved for hip arthritis? No. The FDA says regenerative medicine therapies haven't been approved for any orthopedic condition, including osteoarthritis and hip pain [15][16].
Is hip osteonecrosis the same as hip arthritis? No. Osteonecrosis is bone death from poor blood supply [12]. Studies adding bone marrow cells to surgery for it have had mixed results [13][14].
Still have questions?
Hip headlines often blur small before-and-after studies with controlled trials. If you'd like help reading a study or a trial listing, email hello@vivonyx.com or use our Ask page. We'll give you a straight answer, including "the research doesn't know yet" when that's the truth.
Related reading
Educational disclaimer: This article is for general educational purposes only and is not medical advice, diagnosis, or treatment. It does not describe or suggest the treatment, cure, or prevention of any disease or condition. Regulatory status can change; check the cited FDA pages for current information. Talk with a qualified, licensed healthcare professional before making any medical decision.
References
MedlinePlus (U.S. National Library of Medicine). Osteoarthritis. https://medlineplus.gov/ency/article/000423.htm
Steiner P, Seist T, Moser L, et al. Systematic evidence analysis of symptom modification in hip osteoarthritis following MSC-based interventions. Wien Klin Wochenschr. Published online September 28, 2026. PMID: 42803956. https://pubmed.ncbi.nlm.nih.gov/42803956/
Giorgino R, Alessandri Bonetti M, Migliorini F, et al. Management of hip osteoarthritis: harnessing the potential of mesenchymal stem cells, a systematic review. Eur J Orthop Surg Traumatol. 2024;34(8):3847-3857. PMID: 39254726. https://pubmed.ncbi.nlm.nih.gov/39254726/
Perez OF, Warburton C, Philippon MC Jr, et al. The efficacy of bone marrow stem cell therapy in hip osteoarthritis: a scoping review. HSS J. 2025;21(4):434-444. PMID: 39564400. https://pubmed.ncbi.nlm.nih.gov/39564400/
Silveira Santiago M, Valeriano Zamora F, Machinski E, et al. Clinical response to joint infiltration with bone marrow aspirate in hip osteoarthritis: a systematic review and single-arm meta-analysis. Pain Physician. 2024;27(10):E1033-E1044. PMID: 39688823. https://pubmed.ncbi.nlm.nih.gov/39688823/
Mardones R, Jofré CM, Tobar L, et al. Mesenchymal stem cell therapy in the treatment of hip osteoarthritis. J Hip Preserv Surg. 2017;4(2):159-163. PMID: 28630737. https://pubmed.ncbi.nlm.nih.gov/28630737/
Natali S, Screpis D, Romeo M, et al. Is intra-articular injection of autologous micro-fragmented adipose tissue effective in hip osteoarthritis? A three year follow-up. Int Orthop. 2023;47(6):1487-1492. PMID: 36302901. https://pubmed.ncbi.nlm.nih.gov/36302901/
Hernigou P, Centeno CJ, Berger DR, et al. Intraosseous bone marrow concentrate delays total hip arthroplasty in osteoarthritis: a fifteen year matched cohort study with dose-response analysis. Int Orthop. 2026;50(7):1617-1626. PMID: 42301272. https://pubmed.ncbi.nlm.nih.gov/42301272/
Jiang Z, Chen Y. Clarifying the interpretation of total hip arthroplasty free survival after intraosseous bone marrow concentrate for hip osteoarthritis. Int Orthop. 2026;50(10):2763-2764. PMID: 42658267. https://pubmed.ncbi.nlm.nih.gov/42658267/
Gibbs AJ, Gray B, Wallis JA, et al. Recommendations for the management of hip and knee osteoarthritis: a systematic review of clinical practice guidelines. Osteoarthritis Cartilage. 2023;31(10):1280-1292. PMID: 37394226. https://pubmed.ncbi.nlm.nih.gov/37394226/
Scott P, Hegarty CJ, Kang L, et al. Orthobiologic injections for hip osteoarthritis: a systematic review of clinical outcomes. Orthop Rev (Pavia). 2025;17:151461. PMID: 41450485. https://pubmed.ncbi.nlm.nih.gov/41450485/
MedlinePlus (U.S. National Library of Medicine). Osteonecrosis. https://medlineplus.gov/ency/article/007260.htm
Hauzeur JP, De Maertelaer V, Baudoux E, et al. Inefficacy of autologous bone marrow concentrate in stage three osteonecrosis: a randomized controlled double-blind trial. Int Orthop. 2018;42(7):1429-1435. PMID: 28988340. https://pubmed.ncbi.nlm.nih.gov/28988340/
Li M, Ma Y, Fu G, et al. 10-year follow-up results of the prospective, double-blinded, randomized, controlled study on autologous bone marrow buffy coat grafting combined with core decompression in patients with avascular necrosis of the femoral head. Stem Cell Res Ther. 2020;11(1):287. PMID: 32678055. https://pubmed.ncbi.nlm.nih.gov/32678055/
U.S. Food and Drug Administration. Important Patient and Consumer Information About Regenerative Medicine Therapies. https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies
U.S. Food and Drug Administration. Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes
ClinicalTrials.gov (U.S. National Library of Medicine). Search: hip osteoarthritis, stem cell. https://clinicaltrials.gov/search?cond=Hip%20Osteoarthritis&intr=stem%20cell
ClinicalTrials.gov. NCT03608579: Autologous culture expanded adipose derived MSCs for treatment of painful hip OA. https://clinicaltrials.gov/study/NCT03608579