It is a common misconception that knee pain is a single condition with a universal cure, whether through stem cell therapy, injections or surgery. But knee pain is a symptom, not a diagnosis, says Dr Francis Wong.
The underlying causes may include cartilage damage, a meniscus tear, ligament instability, arthritis, inflammation or even conditions originating elsewhere in the body. Therefore, treatment should start with an accurate diagnosis, says the medical director of Oxford Cartilage & Sports Centre.
A false notion is also that stem cell therapy guarantees regeneration. The term has become something of a marketing buzzword, Dr Wong notes. “Regenerative medicine is an exciting, rapidly evolving field—but it is not magic. No responsible doctor should promise guaranteed cartilage regrowth or a cure. Patients deserve honesty, not hype.”
That measured view comes from years of work in both the operating theatre and the laboratory. As Singapore’s only orthopaedic surgeon-scientist with a PhD in cartilage regeneration—and one of the few in Asia— Dr Wong specialises in cartilage treatment and surgery. He has performed more than 500 cartilage repairs, one of the highest volumes here.
His decision to pursue a PhD in cartilage regeneration while already practising as a surgeon stemmed from a desire to push the envelope.
“I have never been satisfied with accepting ‘this is the best we can do’. ”
Dr Francis Wong on choosing to pursue academic surgery
As a scientist, he has achieved key breakthroughs like pioneering cell-free injectable regeneration based on mesenchymal stromal cell (MSC) exosomes. Exosomes, he explains, are tiny, naturally released particles that carry biological signals capable of shaping tissue response to injury. Instead of transplanting living cells into the joint, this approach leverages these biological messages to activate the body’s own healing.
He also uses laboratory-cultured MSCs to slow or halt joint degeneration. “I often describe MSCs as astute interior designers,” he says. “Interior designers don’t make the bricks, timber or furniture that create a beautiful home; they orchestrate them to achieve the best outcome. Similarly, MSCs do not create cartilage from nothing. They communicate with surrounding tissues, regulate harmful inflammation, and coordinate natural repair processes.”
Not that research is about chasing the next breakthrough, he emphasises. It has always been about broadening treatment options: “That has always driven my work in both the laboratory and the operating theatre.”
Dr Wong believes the next five to 10 years will see a paradigm shift from treating damaged joints to preserving and restoring them. Advances in regenerative medicine, biomaterials, imaging, biologics, and personalised rehabilitation could enable earlier intervention, more precise treatment, and slower progression of joint disease before it becomes irreversible.
That said, he does not believe total knee replacements will become obsolete. They remain a landmark achievement in modern orthopaedic surgery and transform the lives of patients with advanced arthritis. The aim, he says, is to help suitable patients retain their natural joints for as long as possible.
Dr Wong advises not to ignore persistent joint stiffness or pain. As with many body tissues, cartilage responds best to early diagnosis. Small injuries can become larger issues, and joint instability or meniscal injuries can ultimately accelerate cartilage wear if left untreated.
Keep active, too. Joint health is improved by appropriate exercise. Strong muscles protect the knee, improve stability, and reduce joint stress. Rather than avoiding movement, individuals should choose the right activity for their conditions.
“Movement is medicine, but it must be the right movement, at the right time, for the right joint.”
Photography Mun Kong & Hizuan Zailani
Art direction Annalisa Espino Lim
Grooming Keith Bryant Lee using Kevin Murphy & Make Up For Ever
