Ortho Ried
Expanding Joint Care through Regenerative Orthopaedics

What clinical cases show the potential range of regenerative orthopaedic care?

A 24-year-old football player walks into a clinic in Austria with a kissing lesion in his knee, cartilage damage on both sides of the joint and a failed surgery behind him. He can no longer play and believes his career is over. When all hope was lost, he was offered an alternative: stem cell therapy. Nearly three years later, he is back on the field, playing in the Austrian second league without pain.

At the other end of the clinical spectrum was an elderly man who had already survived three heart attacks. Joint replacement was too risky. Surgery was no longer a practical answer, yet pain was still shaping his life. He received stem cell therapy combined with plasma and magnetic-field treatments. The response was not immediate. But after five sessions and six months, he was pain-free. He no longer needed a knee prosthesis.

For Dr. Thiago Tomazi, orthopaedic and trauma specialist, and CEO of Ortho Ried in Ried im Innkreis, Austria, these cases are not outliers. They are part of a broader clinical pattern.

Across about 200 cases reviewed at Ortho Ried, pain scores and WOMAC-style functional assessments showed consistent improvement in movement and pain reduction.

That said, Dr. Tomazi is careful to note that not every patient became completely pain-free, and not every case ruled out the possibility of surgery later. Making that distinction is important because Ortho Ried’s regenerative therapies are not positioned as a replacement for every surgical decision, but as a way to give selected patients more function, less pain and more time before invasive intervention becomes necessary.

Where the Gap Lives

A patient with chronic knee or shoulder pain is often presented with two paths. Manage it with injections and painkillers. Or replace the joint. Tomazi argues that between those two endpoints, a wide clinical territory remains underserved.

“Often, people are told by somebody who can do just one thing that there is only one way to a solution,” says Tomazi. “I believe everybody also has the right to know what the possibilities of treatment are.”

His own formation gave him an unusually wide view of those possibilities. He began his medical education in Brazil, then studied in Verona and Bologna, moved to Leiden in the Netherlands, trained in Bolzano, Vienna and Switzerland before settling in Austria. He sources techniques and technology from providers across South Korea, the US, Turkey, Israel and Europe.

“Movement is life for me,” says Tomazi.

Everything in his clinical model flows from that premise. Ortho Ried combines conservative orthopaedic care, biologic treatment protocols and surgical expertise.

Reading the Patient, Not Running a Protocol

Why does patient stratification matter before selecting a regenerative orthopaedic protocol?

Regenerative orthopaedic care works best when the patient is evaluated as a system, not as an isolated joint.

Often, people are told by somebody who can do just one thing that there is only one way to a solution. I believe everybody also has the right to know what the possibilities of treatment are.

Ortho Ried starts with stratification. Structural damage, symptom pattern, tissue quality, range of motion, fluid accumulation, prior treatments, comorbidities, nutrition and medication history all feed into how Tomazi designs a treatment plan. Diagnosis begins with an X-ray and often proceeds to an MRI. Imaging determines whether a patient is a candidate for stromal vascular fraction (SVF) derived from fat tissue, bone marrow or a combination. It also reveals subchondral bone problems, bone edema and tendon and ligament pathology, requiring thinking beyond cartilage alone.

Tomazi treats bone and cartilage as one osteochondral unit. That changes treatment selection. A lean, athletic patient with little usable fat may need bone marrow harvesting. A patient with bone involvement beneath the cartilage may require bone marrow-targeted intervention. Many receive combined protocols when tissue profile supports it.

Diagnostics extend further still. Lab panels go beyond standard blood work to include vitamin D, minerals, amino acids and analysis of blood, urine and faeces. For patients with systemic or rheumatic conditions, Ortho Ried evaluates gut flora and screens for intestinal permeability. Tomazi draws on the intestine-joint axis theory. When gut bacteria are not functioning properly, gaps can form in the intestinal wall, allowing bacteria and toxins into the bloodstream. That triggers systemic inflammation, which can in turn drive joint inflammation. Screening for leaky gut becomes part of treatment planning for these patients.

What Happens in the Room

In what way does the procedure combine harvesting, injection and supportive therapies?

Treatment takes one to two hours. Everything is done under local anaesthesia; no general anaesthesia, spinal infiltration or hospital bed. Tomazi uses minimally invasive instruments and very small needles. Most patients barely notice the bone marrow extraction as it happens. Most stand up, walk out and go home without crutches. Many need no pain medication at all.

Tomazi works alongside nurse practitioner Mag. Tanja Jakob-Tomazi, who helped develop the technique and is present during every procedure. They travel together as a team, which allows the same workflow and patient experience to be maintained across locations. The procedure varies by case but may combine fat-derived stem cell preparations, bone marrow-derived cells, platelet-rich plasma (PRP), autologous conditioned plasma (ACP), cross-linked hyaluronic acid gels and exosomes for patients who need a stronger therapeutic response.

“I take as many cells as I can,” says Tomazi. “I think more is better in this case.”

Behind that sits a technical challenge he has studied closely. Mechanical separation of harvested stem cells yields roughly 18 to 30 per cent of living cells, a figure he and colleagues confirmed using a cell counter. Enzymatic separation, permitted in Germany under certain conditions but not in Austria, yields up to 90 per cent. Four major partners supply technology and technique selection is matched to case, jurisdiction and clinical need.

Harvesting and injection are only one layer. Tomazi argues that most providers stop at transplantation. Growth factors, delivered via PRP or ACP, are administered in staged intervals after the procedure to support cells already in the joint. Micronutrient support such as chondroitin sulfate, MSM and glucosamine sulfate is standardised. Magnetic field therapy targets cellular function at the mitochondrial level. Intravenous protocols using NAD+, vitamins and amino acids address systemic recovery capacity. Physiotherapy or exo-robotic assistance enters the plan when rehabilitation warrants it.

Who This Serves

To what extent can regenerative care support patients who cannot pursue surgery?

Young patients who want to preserve their joints sit alongside older or medically fragile patients whose cardiac risk or general health makes surgery unsafe and patients in the middle who live with real pain and declining function but are not ready or suited for full replacement. For the oldest patients, those who will never qualify for surgery again, stem cell therapy provides a durable alternative to repeated cortisone injections, which offer only short-term symptom masking. Stem cell therapy lasts longer and addresses the underlying inflammatory process.

“Stem cells do not replace surgery,” says Tomazi. “They are an alternative to conservative treatments.”

They delay or postpone replacement or provide palliative relief when no surgical option remains.

Results vary. Weight, diet, alcohol use and broader health habits influence durability. Some patients will eventually need joint replacement. Tomazi’s objective is to delay that moment. Even partial improvement shifts quality of life in ways that extend well beyond the joint. Patients who lived in constant pain describe being able to talk to their children again, reconnect with a spouse and return to something resembling normal life. Restored movement supports mood, relationships and the willingness to stay active.

Growing the Model

Austria’s regulatory framework permits combinations of biologic therapies that are restricted in other countries. “Legally, I live in quite a paradise for these things,” says Tomazi. Some treatments allowed in Austria are unavailable in the US, Germany, Switzerland or parts of the Middle East.

He is expanding the model into Germany with a new clinic in Bad Füssing, Bavaria, near Munich Airport. About two to three million people visit each year for its natural thermal mineral water, the only designated healing water in Germany.

“I think two or three million people are not mistaken when they say it helps their joints,” says Tomazi.

The German clinic also opens regulatory access to enzymatic cell separation and advanced imaging, including a new machine that documents arthrosis, cartilage condition, bone edema and soft tissue injuries in greater detail. More expansion is planned in Switzerland and Austria.

Growth is equally about method. Tomazi teaches at congresses, hosts visiting physicians and trains other orthopaedic surgeons in protocol design and transplantation workflow. He travels to exchange knowledge with peers in Madrid, Germany, Switzerland, Dubai and many other destinations in a single year. His peer network includes ROC-Aschheim near Munich, one of the most advanced regenerative orthopaedic institutes in Germany, where ongoing exchange reinforces the broader direction both practices share. He has secured an agreement with a Dubai-based company for allogeneic stem cells derived from umbilical cord tissue, available in Austria under tightly restricted conditions for rare, treatment-resistant systemic diseases. For mainstream orthopaedic use, he maintains a strong preference for fresh autologous cells.

What Comes Next

Tomazi expects regenerative medicine to grow steadily. Joint replacement will remain necessary. But the direction is clear. Orthopaedics should move towards extending cartilage lifespan, preserving native joint function longer and making replacement the last option rather than the default progression.

“I hope that one day, when I need it, when my mother needs it, when my children need treatment for a joint, there will be another solution instead of cutting and putting a metal or plastic part inside of us. I hope we will look back one day and say, ‘What were we doing? Putting metal parts in and fixing them with cement or screws in the bone.’ Now we can regenerate instead of replacing joints,” says Tomazi.

That is Ortho Ried’s bet. It doesn’t indicate that surgery will disappear, but it definitely means regeneration will make it rarer, and that patients will finally learn that options exist before anyone picks up a scalpel.