09/18/2026
I’m always looking for evidence-based, non-surgical options that can help preserve joint function, maintain performance, and improve quality of life.
And in this case, the investigation is personal.
I’m in the early stages of osteoarthritis in both knees, confirmed by x-rays and MRIs.
So I’m actively researching what I can do now to protect them, stay highly active, and hopefully avoid knee replacement later in life.
At the same time, I’m vetting practitioners and treatment options that may ultimately be valuable for my clients and followers.
That’s what brought me to Dr. Ron Torrance at his St. Pete Regenexx office.
For nearly a decade, Dr. Torrance has focused on non-surgical orthopedic treatment of knees, shoulders, hips, backs, and other musculoskeletal conditions.
We spent considerable time reviewing his evaluation process, imaging, injection techniques, and the evidence behind the protocols he uses.
One of the most interesting concepts we discussed was WHERE regenerative treatments are delivered in an arthritic knee.
Osteoarthritis isn’t simply “worn-out cartilage.”
The underlying SUBCHONDRAL BONE, the bone immediately beneath the cartilage, can develop abnormal remodeling, bone-marrow lesions, cystic changes, and other pathology that may contribute to pain and progression of the disease.
That makes treatment location potentially very important.
A conventional knee injection typically places PRP or bone-marrow-derived cells into the intra-articular joint space.
Dr. Torrance uses real-time imaging to precisely guide treatment into the specific structures involved in the pathology, including, when appropriate, the subchondral bone itself.
I asked him to show me the evidence.
And there is some very interesting evidence.
A randomized controlled study published in International Orthopaedics followed 60 patients with osteoarthritis in both knees.
Researchers divided the same bone-marrow concentrate between the two knees:
• One knee received the cells directly into the subchondral bone of the femur and tibia.
• The other knee received the same treatment dose through a conventional intra-articular joint injection.
That study design is especially interesting because each patient essentially served as his or her own control.
At two years, the researchers reported greater clinical and MRI improvement in the knees treated through the subchondral bone.
Even more interesting was the long-term follow-up.
After an average of 15 years, only 12 of 60 knees (20%) treated through the subchondral bone had progressed to total knee replacement.
By comparison, 42 of 60 knees (70%) treated with the same cells through the joint space ultimately underwent knee replacement.
Put in my Made Simple way:
80% of the subchondral-treated knees avoided knee replacement versus only 30% of the joint space treated knees.
That does NOT mean every arthritic knee should receive this treatment, nor does one study establish that this approach is universally superior for every patient.
But it certainly got my attention.
This is exactly the type of research I want to continue investigating.
I’m interested in treatments that have:
• A plausible biological mechanism
• Objective imaging or outcome data
• Appropriate patient selection
• Precision-guided delivery
• Enough evidence to justify taking a serious look
Not simply the newest thing being marketed as “regenerative medicine.”
Dr. Torrance also walked me through how, in many cases, he recommends a lower-cost option because it will get the job done.
What’s best for the patient is what is best for him.
And that is refreshing!
The takeaway for me is that regenerative orthopedics is a viable option when the protocol and practitioner are both correct.
It’s not simply:
“Inject some stem cells into a knee.”
It’s identifying the actual pathology, determining which structures need treatment, and using image guidance to precisely place the therapeutic material where it may have the greatest biological effect.
And that distinction may matter considerably.
I’ll continue sharing what I learn as I investigate emerging strategies in health, longevity, human performance, and quality of life…
both for myself and for the people who trust me to help them make informed health decisions.
If you’re dealing with knee, shoulder, hip, or back problems and want to know more about what I learned from Dr. Torrance, feel free to reach out.
Strong is Young!
Coach Matt
TrYumph Functional Training
Regenexx
