Iranian Orthopedic Association Iranian Journal of Orthopedic Surgery 1735-2967 24 1 2025 12 22 Innovative Treatment Approaches for Knee Osteoarthritis: From Injections to Regenerative Surgery (Review Article) Innovative Treatment Approaches for Knee Osteoarthritis: From Injections to Regenerative Surgery (Review Article) 28 38 246021 10.22034/ijos.2025.246021 FA Farshad Shayanmehr Department of Orthopedic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran 0009-0003-8786-2147 Zahra Jodari Mohammadpour Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 0009-0003-8786-2147 Anis Ranjbarzad Hagh Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Asghar Elmi Shohada Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Journal Article 2025 08 01 <span lang="EN-CA">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.</span> <span lang="EN-CA">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.</span> https://www.ijos.ir/article_246021_fc7c24e86f5ddaadf510e416f7fb8c20.pdf