Stem Cell Therapy for Hip Pain in Dallas: An Alternative to Hip Replacement

What Causes Hip Pain?

The hip joint is one of the body’s largest weight-bearing joints. Over time, injury, inflammation, repetitive stress, and aging can damage the cartilage and surrounding tissues that keep the hip moving smoothly.

Hip Osteoarthritis

Hip osteoarthritis occurs when cartilage in the joint gradually wears down. Without healthy cartilage, bones may rub together, causing pain, stiffness, swelling, and reduced mobility. Symptoms often include groin pain, hip stiffness, difficulty walking, pain climbing stairs, reduced range of motion, and limping.

Hip Bursitis

Bursae are small fluid-filled sacs that cushion the hip joint. When these sacs become inflamed, patients may experience sharp pain on the outside of the hip.

Labral Tears

The labrum is a ring of cartilage surrounding the hip socket. Tears may occur from sports injuries, trauma, or degeneration and can cause clicking, locking, and instability.

Tendonitis

Inflamed tendons around the hip can create pain during movement and exercise.

Femoroacetabular Impingement

Femoroacetabular impingement, also called FAI, occurs when abnormal bone growth creates friction inside the hip joint, damaging cartilage over time.

Avascular Necrosis

Reduced blood flow to the hip can lead to bone tissue death and progressive joint deterioration.

Sports Injuries and Trauma

Falls, accidents, repetitive impact, and athletic injuries can damage the cartilage, tendons, ligaments, and surrounding tissues of the hip. Read more about hip arthritis causes and symptoms.

Traditional Treatments for Hip Pain

Most patients begin with conservative treatments such as anti-inflammatory medications, steroid injections, physical therapy, activity modification, pain medications, and assistive devices. While these treatments may temporarily reduce symptoms, they often do not address the underlying degeneration. When conservative care fails, many patients are advised to consider hip replacement surgery.

How Stem Cell Therapy for Hip Pain May Work

At Innovations Stem Cell Center, we use stem cells from your own adipose (fat) tissue, one of the body’s richest sources of mesenchymal stem cells. Research suggests these cells may help by:

• Calming inflammation
• Releasing growth factors and signaling molecules
• Supporting tissue repair
• Supporting healthier joint function

Unlike steroid injections, which mainly reduce pain and inflammation temporarily, stem cell therapy aims to support the body’s own healing environment. These effects are still being studied, and individual results vary.

Why We Use Adipose-Derived Stem Cells

Our adipose-derived process typically yields about 100 million cells per treatment, compared with roughly 100,000 typically obtained from bone marrow. We count the cells for every patient.

• About 100 million cells per treatment
• Minimally invasive harvest (about 50cc of fat)
• Same-day processing and treatment
• Your own cells

What the Research Says

Research on injecting a patient’s own fat-derived cells into an arthritic hip is still early. Here is a plain summary of what peer-reviewed studies have found, including results that weren’t positive.

• Reviews of hip studies. A 2025 scoping review found 9 clinical studies of cell-based injections for hip osteoarthritis, including fat-derived preparations. Pain scores dropped by roughly 30–50% on average, and side effects were rare and mild. Evidence of cartilage repair on imaging was limited and inconsistent. The authors called for randomized trials [1]. A 2026 systematic review of 9 studies (307 patients) also reported improvements in pain and function. It concluded that small, mostly uncontrolled studies don’t yet allow firm conclusions about how well the treatment works or whether it changes the joint [2].
• A three-year follow-up. In an Italian study of 55 patients with early hip osteoarthritis who received an ultrasound-guided injection of their own processed fat tissue, 28 needed no further treatment at about three years. 10 had another injection, and 17 went on to hip replacement (on average about 16 months later). Results were most favorable in early to moderate arthritis [3].
• A larger cohort. A 2025 Japanese study followed 168 hips (129 patients) treated with injections of the patients’ own fat-derived cells. Average hip scores improved at 1, 3 and 6 months. Patients with moderate arthritis improved more than those with mild arthritis. The authors worked at the clinic that provided the treatment [4].
• A caution from a placebo-controlled trial. In a European randomized trial in knee osteoarthritis, a single injection of lab-grown fat-derived cells did not improve pain or function more than a saltwater (placebo) injection at 6 months [5]. Placebo-controlled results like this are an important reason we never promise an outcome.

Limitations we want you to know about. Most hip studies are small and uncontrolled (there is no comparison group). They follow patients for months to a few years, and they prepare cells in different ways. None of them tested our exact combination of a hip injection, an IV dose and acoustic wave therapy (AWT). Improvements in pain scores don’t mean cartilage has regrown. Some patients get little or no relief.

FDA status. This treatment is not FDA-approved. It is a same-day, in-office procedure that uses your own tissue: a small amount of your fat is collected, prepared in our clinic, and returned to you during the same visit. The FDA publishes information for patients considering regenerative medicine treatments. We encourage you to read it and bring your questions to your consultation.

References

1. Reali GE, Araujo Fernandes D, Campos Martins E. Outcomes Following Stem Cell-Based Therapies for Hip Osteoarthritis: A Scoping Review. Cureus. 2025;17(11):e96419. PubMed 41376753
2. Steiner P, Seist T, Moser L, et al. Systematic evidence analysis of symptom modification in hip osteoarthritis following MSC-based interventions. Wien Klin Wochenschr. 2026 (online ahead of print). PubMed 42803956
3. 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. PubMed 36302901
4. Hatano M, Ishikura H, Terao T, et al. Intra-articular administration of autologous adipose-derived stem cells in hip osteoarthritis: Longitudinal treatment trajectories and prognostic factors. Regen Ther. 2025;29:217-226. PubMed 40225053
5. Pers YM, Schrezenmeier H, Fleury-Cappellesso S, et al. Effect of intra-articular adipose-derived mesenchymal stromal cell versus placebo injection on pain and function in patients with knee osteoarthritis: the ADIPOA2 phase 2b randomised clinical trial. Ann Rheum Dis. 2025;84(12):2103-2114. PubMed 40885690

One Flat Fee for Up to 4 Joints

Many adults with hip arthritis have more than one sore joint. Our $16,500 flat fee, AWT included, covers up to 4 joints in the same visit, such as both hips, or a hip plus knees or shoulders, along with an IV dose. It covers only joints that actually need treatment: Dr. Johnson examines each joint, and we don’t inject a joint that has no problem. The IV portion delivers cells throughout the body. Individual results vary. A second treatment, if needed, is $10,000, including AWT.

Benefits Patients Look For

1. Less hip pain: many patients report less pain and stiffness. Individual results vary.
2. Better mobility: many patients report easier walking, stairs and range of motion.
3. No major surgery: done in-office under local anesthesia, with no hospital stay.
4. Little downtime: most patients resume normal activities within a day or two; we recommend skipping vigorous exercise for a few days.
5. Your own cells: cells come from your own body, which lowers the risk of an immune reaction (bruising, soreness and infection are still possible).
6. May help delay hip replacement: some patients are able to postpone surgery.
7. Several joints, one visit: up to 4 joints that need treatment, plus an IV dose and AWT, under one fee.

Hip Osteoarthritis, Labral Tears and Avascular Necrosis: What We Evaluate

Every hip is different, so the first step is an exam and a careful look at your X-rays or MRI. These are the three hip problems we’re asked about most, and what we can and can’t offer for each.

Osteoarthritis of the hip

Osteoarthritis is the gradual wear of the cartilage that lines the hip socket and the ball of the thigh bone. It usually causes groin or front-of-thigh pain, morning stiffness and trouble with stairs, socks and shoes. It is the hip condition with the most published research on injected cell treatments (see “What the Research Says”). In those studies, people with mild to moderate arthritis tended to do better than people with advanced, bone-on-bone disease. Many of our hip patients come in with osteoarthritis. Many report less pain and easier walking; results vary.

Hip labral tears

The labrum is a rim of cartilage that deepens the hip socket. Tears can cause clicking, catching, locking and a deep pinching pain in the groin. Many tears are linked to hip impingement (FAI) or to arthritis. A tear that causes true locking, or one caused by a bone shape problem, may need arthroscopic surgery. Research on injected cells specifically for labral tears is very limited. At your consultation, Dr. Johnson will review your MRI and tell you whether the treatment is reasonable to try or whether a surgical opinion makes more sense.

Early avascular necrosis (osteonecrosis)

Avascular necrosis happens when the blood supply to the ball of the hip is reduced and bone tissue starts to die. Risk factors include long-term steroid use, heavy alcohol use and some medical conditions. Stage matters most. Before the bone collapses, some patients look for options to protect the joint. Once the ball has collapsed, hip replacement is usually the right answer. Most published research on cell-based treatment for avascular necrosis involves surgery that places cells directly into the bone (core decompression), which is a different procedure from ours. We will only discuss treatment if your imaging shows early-stage disease, and we will be clear about the limits of the evidence.

We also evaluate hip bursitis, tendon problems and hip impingement. If your pain is actually coming from your lower back, we’ll tell you that, too.

What Results Can I Expect?

Patients who choose stem cell therapy for hip pain often report less pain, better range of motion and easier walking. Some notice a change within days as inflammation settles; others improve gradually over several months. Some patients choose a second treatment 6–12 months later. Many patients report improvement, but not everyone improves. Individual results vary.

Your Hip Procedure, Step by Step

Everything happens in our Dallas office under local anesthesia. You’re awake the whole time. The treatment day averages about 4 hours.

• Step 1, Consultation and evaluation: Dr. Bill Johnson reviews your history, imaging and goals and tells you honestly whether you’re a good candidate. Virtual consults are available before you travel.
• Step 2, Fat harvest: Dr. Johnson removes about 50cc of fat from your abdomen or flanks under local anesthesia. It takes only a few minutes.
• Step 3, Processing: your fat is processed in our in-clinic lab to concentrate the cells while you relax.
• Step 4, Hip injection + IV: Dr. Johnson injects the cells into your hip joint himself, using ultrasound imaging to guide the needle, and part of the dose is given by IV. If other joints need treatment (up to 4 in total), he injects those the same day.
• Step 5, Acoustic wave therapy (AWT): Dr. Johnson’s medical staff deliver non-surgical AWT to the treated area. Local patients can split AWT sessions over several days, and out-of-town patients get everything in one day and travel home the next morning. Innovations brought AWT to the USA from Switzerland in 2005.
• Going home: most patients drive themselves home. Local patients can split AWT sessions over several days, and out-of-town patients get everything in one day and travel home the next morning.

Recovery Timeline

Everyone heals differently. The timeline below is what many patients report; your experience may differ, and results vary. Dr. Johnson’s team gives you written aftercare instructions, including guidance on activity and medications. Please follow them over anything general you read here.

Day 1 (treatment day). The treatment day averages about 4 hours under local anesthesia, with no hospital stay and no general anesthesia. Most patients walk out on their own and drive themselves home. Expect soreness and some bruising at the fat-harvest site, and a deep ache in the hip. Rest, stay hydrated and keep moving gently around the house.

Week 1. Soreness at the harvest site usually fades over several days. Many patients return to desk work the next day and to normal light activity within a day or two. Walking is encouraged. Avoid running, heavy lifting and intense workouts until you’re cleared. Local patients may still be finishing their acoustic wave therapy (AWT) sessions this week.

Weeks 2–6. Most patients gradually return to their usual routine. Some notice early changes as inflammation settles; others notice little at this stage, which is common and not a sign the treatment failed. Low-impact activity such as walking, cycling and swimming is usually fine as comfort allows. Some patients add physical therapy to rebuild strength around the hip.

Months 3–6. This is when many patients report the most noticeable change in pain, stiffness and walking. Others improve less, or not at all. We check in on your progress, and some patients choose a follow-up treatment.

Who Is (and Isn’t) a Good Candidate?

You may be a good candidate for hip stem cell therapy if you:

• Have chronic hip pain lasting 3+ months
• Have been diagnosed with hip arthritis or cartilage damage
• Want to avoid or delay hip replacement surgery
• Have tried physical therapy, medications, or injections without lasting relief
• Are in overall good health
• Have no active cancer or infection

Stem cell therapy isn’t right for everyone. Severe, bone-on-bone hips may respond less, and Dr. Johnson will discuss that with you openly.

Who Isn’t a Good Candidate

Stem cell therapy isn’t the right choice for everyone. We may advise against it, or ask you to see a surgeon or your own doctor first, if you have:

• a collapsed hip (late-stage avascular necrosis) or severe bone-on-bone arthritis with deformity
• a hip problem that needs surgery to fix, such as a fracture, a loose fragment or a tear that locks the joint
• active cancer, or cancer treatment within a time frame your oncologist hasn’t cleared
• an active infection anywhere in the body, or a skin infection near the hip or the harvest site
• uncontrolled diabetes or another uncontrolled medical condition
• a bleeding disorder, or blood thinners that can’t be safely managed around the procedure (we decide this case by case with your prescribing doctor)
• an expectation of a certain result or a quick fix; improvement, when it happens, usually builds over months

Who Performs Your Treatment: Dr. Bill Johnson

Dr. Bill Johnson has been a physician since 1983 and is board-certified in internal medicine. He has offered stem cell therapy at Innovations since late 2012 (nearly 14 years) and personally performs the fat harvest and the ultrasound-guided hip injection. His medical staff deliver the AWT. Innovations also brought acoustic wave therapy (AWT) to the USA from Switzerland in 2005. Read Dr. Johnson’s bio.

Cost

$16,500 flat fee, for up to 4 joints. Your first treatment is one price, and it includes:

• consultation and medical evaluation with Dr. Bill Johnson
• the fat harvest and same-day processing of your own fat-derived (adipose) cells
• ultrasound-guided injection of your hip, plus up to 3 more joints that need treatment (for example, both hips, or a hip plus knees or shoulders)
• an IV dose
• acoustic wave therapy (AWT), delivered by Dr. Johnson’s medical staff

We only treat joints that have a real problem. We don’t inject a healthy joint just because the fee would allow it.

Follow-up treatment: $10,000 (AWT included), if you and Dr. Johnson decide a second treatment makes sense.

Insurance and financing. Stem cell therapy is not covered by insurance, including Medicare and Medicaid; it’s a cash-pay service. Financing is available. Call (972) 893-9849 and we’ll help you apply.

Frequently Asked Questions

Is stem cell therapy for the hip FDA-approved?

No. This treatment is not FDA-approved for hip arthritis or any other condition. It is a same-day, in-office procedure that uses your own fat tissue, collected and returned to you during one visit. We’ll walk you through what that means at your consultation.

How much does it cost?

$16,500 for the first treatment. That covers up to 4 joints that need treatment, an IV dose and acoustic wave therapy (AWT). A follow-up treatment, if needed, is $10,000. Insurance and Medicare don’t cover it, but financing is available.

Can stem cells help a torn hip labrum?

Some patients with labral tears report less pain after treatment, but research specific to labral tears is very limited and results vary. Tears that lock the joint or are caused by bone shape (impingement) may need surgery. Dr. Johnson will review your MRI and give you an honest opinion.

Does it work for bone-on-bone hips?

Severe, bone-on-bone hips tend to respond less, and in published studies people with milder arthritis generally did better. If your hip has collapsed or is badly deformed, a hip replacement is usually the better option, and we’ll tell you so.

Will I still need a hip replacement later?

Possibly. Some patients use this treatment to delay surgery, and some avoid it, but some still go on to have a replacement. In one three-year study, about a third of patients eventually did [3]. Having this treatment doesn’t rule out surgery later.

How long until patients notice a change?

Some patients notice less pain within days or weeks as inflammation settles. Many report the biggest change between months 3 and 6. Some patients don’t improve. Results vary.

Is the procedure painful, and who performs it?

Most patients report mild discomfort. Dr. Bill Johnson does the fat harvest and the ultrasound-guided hip injection himself under local anesthesia, and you’re awake the whole time. His medical staff deliver the AWT.

How long has the clinic been doing this?

Innovations Stem Cell Center has offered stem cell therapy in Dallas since late 2012. Dr. Johnson has been a physician since 1983 and is board-certified in internal medicine. To ask about your hip, call (972) 893-9849.