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Who should perform regenerative medicine? The short answer
An orthopedic surgeon, a sports medicine physician, or a physical medicine and rehabilitation (PM&R) physician — specialists trained in musculoskeletal anatomy, image-guided injection, sterile technique, and the biology behind PRP and BMAC. In Honolulu, fellowship-trained hip and knee surgeon Dr. Paul Morton delivers PRP, BMAC, and A2M inside a full joint-preservation program, which means the diagnosis comes first and the biologic is recommended only when it fits.
- Diagnosis first — a biologic aimed at the wrong problem treats nothing
- Image-guided placement — ultrasound or X-ray confirms the needle is in the right structure
- Your own tissue, same day — PRP and BMAC prepared in the visit fit FDA rules; lab-expanded or donor 'stem cells' sold for joints do not
- Every alternative on the table — a provider who can also offer covered injections, therapy, and surgery has no reason to oversell a biologic
- Honest evidence — no cartilage regrowth, results vary, and cash-pay pricing is quoted in writing before you decide
Why the injector matters as much as the injection
Regenerative medicine is one of the fastest-advancing fields in healthcare, promising treatments that help regenerate tissue, relieve pain, and restore function. But every one of these therapies depends on technical know-how: obtaining and preparing platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), or adipose-derived cells (a product Dr. Morton does not offer) is skilled, hands-on work — not something poured from a kit.
As these therapies grow in popularity, so does the number of providers offering them. That makes choosing the right specialist critical, for both effectiveness and safety. Orthopedic surgeons, sports medicine physicians, and physical medicine & rehabilitation (PM&R) physicians are typically the most qualified to administer these treatments. Turning instead to providers without that training — including some general practitioners and chiropractors — risks suboptimal outcomes, because these therapies demand specialized knowledge of anatomy, a real understanding of the underlying science, disciplined sterile technique, and rigorous safety protocols.
The three specialties best trained to deliver these treatments
Orthopedic surgeons
Orthopedic surgeons are experts in the musculoskeletal system, with comprehensive training in both surgical and non-surgical care. They are trained to diagnose and treat structural and degenerative conditions of bones, joints, and soft tissues — which matters here, because a biologic aimed at the wrong diagnosis treats nothing. That expertise is especially important for procedures like BMAC, which requires harvesting bone marrow itself, and for injection therapies like PRP, where precise placement into the affected tissue determines whether the treatment works and complications are avoided.
Sports medicine physicians
Sports medicine specialists focus on physical fitness and the injuries that come from sport and activity. Their training in the dynamics of movement and athletic injury makes them well suited to regenerative treatments such as PRP — and particularly effective at tailoring therapy so athletes recover strength and function without invasive surgery.
Physical medicine & rehabilitation (PM&R) physicians
PM&R — also called physiatry — is dedicated to restoring functional ability and quality of life for people with physical impairments, whether the problem involves the brain, spinal cord, nerves, bones, joints, ligaments, muscles, or tendons. Physiatrists train extensively in building comprehensive management plans that improve how you function day to day, rather than focusing narrowly on a single diagnosis. Their goals — more independence in daily activities and a better overall quality of life — align naturally with what regenerative medicine is trying to achieve.
What non-specialists often lack
Regenerative medicine holds real promise, but its complexity demands a high level of expertise. Plenty of providers are drawn to the potential of these treatments; not all of them have the skills or knowledge to deliver them safely and effectively. Four competencies separate the specialists from everyone else:
| Competency | Why it matters |
|---|---|
| Detailed anatomical knowledge | Effective regenerative medicine requires precise targeting. Without deep anatomical training, injections miss the target — producing ineffective treatment or damaging tissues that were never the problem. |
| Sterile technique | These procedures must strictly follow sterile protocols to prevent infection. Providers without sufficient training or experience in sterile technique expose patients to avoidable complications. |
| Regulatory and safety training | Specialist physicians stay current with the guidelines and safety measures these advanced treatments require. A provider who isn't up to date can compromise patient safety without realizing it. |
| The underlying science | Regenerative medicine is grounded in complex biology — stem cell dynamics, growth factor behavior, tissue engineering. Getting the most out of these therapies means understanding how they actually work, not just how to push a plunger. |
The cost of choosing the wrong provider
When regenerative treatments are delivered by someone without the right training, three outcomes show up again and again:
- Ineffective treatment. A poorly chosen or poorly placed therapy can fail to improve the condition — and in some cases makes the pain and dysfunction worse.
- Safety complications. Inadequate technique can cause infections, adverse reactions, or worse — particularly with procedures that involve injections or aspirations, where a needle is entering a joint or drawing from bone marrow.
- More cost, more frustration. Treatments that don't work don't just waste the original fee. Patients often need additional procedures to correct or salvage the result, prolonging recovery and compounding both the expense and the frustration.
What the FDA says about stem cell clinics
The single most useful vetting fact for a patient comparing clinics is regulatory, not medical. The FDA's consumer warning about stem cell therapies is explicit: stem cell products marketed for arthritis and other orthopedic conditions are, with narrow exceptions, unapproved, and patients have been seriously harmed by them.
The narrow exception matters. Under the FDA's same-surgical-procedure rule (21 CFR 1271.15(b)), a physician may remove your own cells or tissue and put them back in the same procedure without the product being regulated as a drug, provided the tissue is only minimally manipulated — spun in a centrifuge, not cultured or expanded in a laboratory. Same-day PRP and BMAC fit that description. Laboratory-expanded "stem cells," and amniotic, umbilical-cord, or other donor products sold as joint cures, do not. Compliant is also not the same as approved: the FDA has not approved PRP or BMAC as arthritis treatments, which is why insurers call them investigational.
Dr. Morton offers PRP, BMAC, and A2M only — each prepared from your own blood or marrow in the same visit — and his read of the evidence is the same on every page of this site: for osteoarthritis, cell-based injections remain experimental, most studies show minimal improvement, and none has demonstrated that stem cells reliably fix orthopedic problems. BMAC's best evidence is early hip avascular necrosis, not arthritis.
How to vet a regenerative medicine provider
Before agreeing to any regenerative therapy, vet the provider the way you would vet a surgeon — because functionally, that's the level of skill you're paying for:
- Confirm board certification in orthopedic surgery, sports medicine, or PM&R — the specialties actually trained for this work
- Ask exactly what the product is: your own blood or marrow prepared the same day, or a lab-expanded, amniotic, or umbilical-cord product the FDA has warned about
- Ask about their track record with the specific therapy you're considering, not regenerative medicine in general
- Ask how the injection is guided to the target and what sterile protocol is followed
- Ask what else they offer — a clinic that sells only one product has only one answer for every knee
- Expect an honest diagnosis first, a written price before you decide, and a straight statement that no biologic regrows cartilage
Regenerative medicine at Dr. Morton's practice
Dr. Morton is a fellowship-trained hip and knee surgeon who delivers PRP, BMAC, and alpha-2-macroglobulin (A2M) as part of a structured joint-preservation program — diagnosis first, then the least invasive treatment that will actually work. Because he treats the full spectrum from injections to joint replacement, there is no incentive to sell a biologic where it won't help: the recommendation follows the diagnosis, not the other way around.
He sees patients across Hawai‘i at Pacific Bone & Joint — Honolulu (Ala Moana), West O‘ahu (Kunia), Hilo, and Kona. To find out whether regenerative medicine fits your joint, book a consultation or call (808) 439-6201. Bring a photo ID, your insurance card, a medication list, and any prior X-rays or MRI; managed-care and Medicaid/Quest plans may need a referral from your primary care physician, which the office checks before your visit. When an in-person visit isn't practical, a telehealth consultation can review your imaging first.
Medically reviewed by Paul Norio Morton, MD, FAAOS, FAAHKS. Last reviewed: . This article is for education only and isn’t a substitute for an exam and personalized advice — schedule a consultation to discuss your situation.