Iranian Journal of Orthopedic Surgery

Abstract Knee osteoarthritis (KOA) is a common degenerative joint disease that mostly impacts adults over 5 years of age. Its prevalence is considerably higher in women, individuals with excess body weight and people with prior joint trauma. Current treatment strategies primarily focus on symptom control, which underscores the urgent need for more effective and disease-modifying therapies. Recent advances in both nonsurgical and surgical modalities have introduced promising regenerative options. Therapeutic modalities notably mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) have demonstrated substantial potential in attenuating inflammatory responses and facilitating cartilage regeneration, particularly during the early pathological phases of knee osteoarthritis. Intra-articular hyaluronic acid (HA) injections provide only temporary symptomatic relief and show limited long-term efficacy. For advanced cases, surgical interventions including autologous chondrocyte implantation (ACI) and knee arthroplasty (TKA) remain viable options, with their associated risks and complications. Personalized treatment approaches based on disease severity, progression, and patient-specific factors are likely to yield optimal outcomes. Future directions in KOA management may include gene-edited MSCs, smart implants, and the integration of machine learning to enhance therapeutic precision and long-term success.