This review is a literature review based on articles gathered over the previous 10 years from scientific search engines. To divide pain management following total joint arthroplasty into segments. The pain is frequently connected with incision pain induced by surgical damage to a major peripheral nerve and differs in quality and location from pain experienced before surgery. Acetaminophen, nonsteroidal anti-inflammatory drugs, and opioid analgesia are the three categories of medicines used to manage postsurgical pain. These medications can be used as pre-emptive analgesia or as part of a multimodal analgesia regimen. Multimodal analgesia is the most common therapy for postoperative pain following joint replacement. This medication is meant to lessen the risk of negative effects that may arise after taking opioids.

No agreed cure or procedure can prevent the damage caused by OA. Current treatments such as physiotherapy, anti-inflammatory drugs, and viscous supplements are symptomatic and are aimed solely at pain relief. Mesenchymal stem cells, on the other hand, refer to a population of cells with immunomodulatory and homing properties. Recent studies have shown that stem cells produce secretomes with tissue regeneration, immunomodulation, anti-inflammatory, and anti-apoptotic capacities.Secretomes in conditioned media produced by mesenchymal stem cells can stimulate the repair of cartilage defects. There are many evidence from many studies both in vitro and in vivo which provide potential results. The improvement can be seen from the morphology, in the form of thickening of the cartilage, an increase in the number of chondrocyte cells, regular joint surfaces, and histologically it can be seen that there is an improvement in the joint cartilage matrix. Likewise, histological studies using immunohistochemistry also showed an increase in the expression of TGF-β, SOX-9, aggrecan, and type II collagen which is a pathway for the formation of hyaline cartilage repair. Not only improvement, other studies have also shown that the secretome can provide a protective effect on joint cartilage by increasing the expression of the COL2A1 gene which functions to form collagen matrix components and reduces apoptosis in chondrocyte cells.Secretomes produced by mesenchymal stem cells can stimulate the repair of cartilage damage, anti-inflammatory, immunomodulator, angiogenesis, and anti-apoptotic abilities from their cytokines and extra vesicles contains miRNA. MSCs secretomes are more stable and provide simpler manufacturing than MSCs themselves.