Ultrasound-guided orthobiologic injections for knee arthritis, meniscus tears, and tendon injuries, performed by a board-certified orthopedic surgeon who will tell you plainly whether you need a replacement or not. And for arthritis in between, the MISHA implantable shock absorber, first performed in Florida by Dr. Matarazzo.
Same-week appointments. Bring your MRI or X-ray if you have one. If you do not, we image the knee in the room with diagnostic ultrasound.
American Board of Orthopaedic Surgery, Diplomate
American Academy of Orthopaedic Surgeons, Fellow
American Orthopaedic Society for Sports Medicine, Member
Sports Medicine & Arthroscopy Fellowship, Lenox Hill Hospital, New York
Former assistant team physician, NY Jets & NY Islanders; head team physician, Palm Beach Atlantic University
Each of these points to a specific structure. That is why the first visit is an examination and an ultrasound, not a prescription.
Orthobiologics work best when the injection reaches the exact tissue that is failing. These are the knee problems where that precision pays off.
Orthobiologics are treatments derived from your own blood, bone marrow or fat, concentrated in the office and injected into the injured tissue under ultrasound. No incision, no general anesthesia, and no implant.
A blood draw is spun to concentrate platelets and their growth factors, then injected into the joint, tendon or meniscus. Our first-line biologic for mild to moderate knee arthritis, meniscus tears and tendinopathy.
Marrow is drawn from the pelvis under local anesthetic and concentrated to deliver a higher density of cells and signaling proteins. Reserved for moderate to advanced arthritis and larger meniscus injuries, where PRP alone may not be enough.
A small amount of fat is taken from the abdomen or flank, processed without enzymes, and injected into the joint. Provides cushioning and a cell-rich scaffold. The knee is where MFAT has its best track record, particularly bone-on-bone arthritis.
Dr. Matarazzo watches the needle enter the joint, tendon or meniscus in real time, so the biologic lands in the millimeters of tissue that need it. It is also how we confirm the diagnosis before treating it, and how we follow the tissue as it heals.
For arthritis that has outgrown injections but is not ready for a replacement, there is now a third option. Dr. Matarazzo performed Florida's first MISHA implant at Jupiter Medical Center in February 2026.
Through one small incision on the inner knee, a titanium-anchored shock absorber is fixed to the femur and tibia, parallel to the collateral ligament and entirely outside the joint capsule. With every step it compresses and takes over 30 percent of the peak load off the arthritic inner compartment, which is where most knee arthritis lives. Your own cartilage, meniscus and ligaments stay untouched.
It is an outpatient procedure with no weight-bearing restrictions afterward, and because nothing inside the joint is altered, a partial or total knee replacement remains fully available later if you ever need one.
FDA-authorized in 2023, with five-year published follow-up showing 85 to 90 percent of patients still carrying their implant and free of a replacement.
Roughly one in seven patients in the published series had the device removed for discomfort or other reasons; that is a conversation we have with you before, not after. Dr. Matarazzo also performs robotic partial and total knee replacement, so the recommendation you get is the right operation, not the newest one.
The sequence is the same for every patient, even though the plan is not.
History, hands-on testing of the ligaments and meniscus, and a diagnostic ultrasound of the knee in the room. We review any MRI or X-ray you bring.
Which structure is causing the pain, whether it is a candidate for biologics, and if it is surgical, why. You leave knowing your options and the cost.
Blood, marrow or fat is collected and concentrated in the office, then injected under ultrasound guidance. Local anesthetic only. You walk out and drive yourself home.
A short unloading period, then a structured strengthening program. Follow-up ultrasound tracks the joint as it responds.
Dr. Matarazzo has spent more than two decades operating on knees, including as assistant team physician to the New York Jets and New York Islanders and as head team physician for Palm Beach Atlantic University. That experience is exactly why he now leads with regenerative care: he knows which knees need a scalpel and which ones do not.
A knee replacement is a good operation for the right knee. Most of the knees I see are not there yet, and I would rather keep them from getting there.Dr. Marc Matarazzo
Often, yes, for a long time. Mild and moderate arthritis responds well to biologic injections combined with strengthening and weight management. Bone-on-bone arthritis with deformity or a knee that no longer straightens is usually surgical, and we will tell you so at the first visit rather than sell you a treatment that will not work.
MISHA is an implantable shock absorber fixed to the inner side of the femur and tibia, outside the joint, that takes about a third of the load off the arthritic inner compartment with every step. It is for active patients with medial-compartment arthritis who have run out of non-surgical options but are too young or too active for a replacement. Dr. Matarazzo was the first surgeon in Florida to perform it. The examination, X-rays and ultrasound at your first visit tell us whether your knee fits.
Most degenerative meniscus tears in patients over 40 do no better with surgery than without it, and removing meniscus tissue accelerates arthritis. Acute tears that lock the knee are different. Examination and ultrasound tell us which one you have.
Cortisone suppresses inflammation and can give fast relief, but it does nothing to heal the tissue and repeated doses damage cartilage. Hyaluronic acid gel lubricates for a few months. Orthobiologics are slower to work, typically weeks rather than days, because they are stimulating a repair response rather than masking a signal.
The blood draw feels like any lab draw. Marrow and fat harvest are done under local anesthetic and are well tolerated. The injection itself is brief. Most patients describe two or three days of soreness and fullness in the knee afterward, which is a normal part of the response.
Most patients notice improvement between two and six weeks, with continued gains out to three months as the tissue remodels. For knee arthritis, relief commonly lasts a year or more and can be repeated. Tendon and meniscus problems that heal tend to stay healed.
The consultation, examination and diagnostic ultrasound are typically billable to insurance. Orthobiologic injections themselves are generally not covered and are offered on a direct-pay basis. You will receive the exact cost in writing before anything is scheduled.
PRP, bone marrow concentrate and micro-fragmented fat are prepared with FDA-cleared devices and use your own tissue in a same-day procedure, which is how they are permitted to be performed. They are not FDA-approved drugs, and results vary from patient to patient. We do not use donor cells, umbilical products or anything that is not your own tissue.
One visit, one examination, one honest answer about whether biologics, rehab or surgery is right for you. Same-week appointments in Palm Beach Gardens, minutes from Jupiter.