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Stem Cell and Regenerative Injections

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What stem-cell and bone-marrow-derived injections claim to do for joints and tendons, what the evidence actually shows, and the safety and regulatory caveats.

Updated Jul 2026
A test tube next to a syringe.
Stem-cell and regenerative injections are widely advertised; robust evidence for musculoskeletal use remains limited. Kieran Hirpara 4.0

What you're feeling

You may notice pain in your knee, especially if you have wear-and-tear arthritis. This discomfort often feels worse after you have been active during the day. You might also feel stiff when you first wake up in the morning. The pain can flare up at night, making it hard to find a comfortable sleeping position.

Daily tasks can become difficult as the condition progresses. Simple movements like standing up from a chair or walking up stairs may cause sharp pain. You might find it hard to bend your knee fully or keep it straight. Some people report that the knee feels unstable or like it might give way.

If you have synovitis, which is swelling and inflammation inside the joint, the pain may be more intense. This is particularly true if your pain is moderate to severe. The swelling can make the knee feel tight and warm to the touch. You might notice that the knee looks puffy or larger than usual.

Your surgeon will assess these symptoms to understand your specific situation. While stem cell injections are being studied for these issues, there is currently insufficient evidence to recommend them for routine clinical practice. The best effects of stem cell treatment for posttraumatic arthritis are often observed on days 7 and 14 after certain procedures, but this is still part of ongoing research.

For now, your surgeon will focus on managing your pain and improving your function through established methods. You may be advised to rest, use ice, or take medication to help with the swelling and discomfort. Physical therapy can also help strengthen the muscles around the knee to support it better.

It is important to communicate clearly with your surgeon about what you are feeling. Tell them when the pain is worst and what activities make it better or worse. This helps them tailor a plan that works for you. Remember that new treatments are always under investigation, but safety and proven results remain the top priority.

What's actually happening

Your knee joint is lined with smooth cartilage. This tissue acts like a shock absorber and a gasket. It lets your bones glide past each other without friction. In osteoarthritis, this coating wears down. The joint becomes inflamed. This swelling is called synovitis. It causes pain and stiffness.

Stem cells are the body’s repair crew. Specifically, mesenchymal stem cells can turn into bone, cartilage, or fat. They help calm inflammation and encourage healing. Your surgeon may use cells from your own bone marrow or fat. They might also use umbilical cord-derived cells. These treatments aim to restore the joint’s natural function.

The timing of these injections matters. For posttraumatic osteoarthritis, the best effects are observed on days 7 and 14 after injury. The schedule of treatment is significantly correlated with how well it works. Combining stem cells with platelet-rich plasma can enhance therapeutic efficacy. This mix has potential as a treatment option for osteoarthritis.

However, we must be clear about the current state of care. There is insufficient evidence to recommend stem cell injections for knee osteoarthritis in clinical practice at this time. Mesenchymal stem cell injections represent a growing area of research. They should continue to be studied in rigorous trials.

Some studies show promise. Intra-articular injection of umbilical cord–derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis. Treatment showed clinical improvement at the end of follow-up. Patients with moderate to severe pain saw particular improvement.

But other results are mixed. The superiority of bone marrow aspirate concentrate over other orthobiologic treatments cannot be assessed given the conflicting results presently available. There is also a significant risk of reporting bias in trials. Abstracts often show better results than the main texts.

The application of these cells should be guided by the pathophysiology of the target disease. It must follow regulatory frameworks to ensure safe and effective use. While exosome-based strategies show theoretical promise, they are not yet standard care. Your surgeon will guide you based on what is proven and safe today.

What to expect

Stem cell injections for knee wear-and-tear arthritis are still an area of active research. There is currently insufficient evidence to recommend these injections for routine clinical practice. Your surgeon may continue to study these treatments in rigorous trials to better understand their role.

Mesenchymal stem cells are a growing focus in orthopaedics and trauma care. These cells are used in clinical practice in accordance with government health regulations. Their use should follow strict regulatory frameworks to ensure safety and effectiveness. The application of these cells must be guided by the specific nature of your joint disease.

If you have post-traumatic arthritis, the timing of treatment matters. The schedule of injections is significantly correlated with how well the treatment works. For some patients, the best effects are observed on days 7 and 14 after injury. Some studies combine platelet-rich plasma with adipose-derived mesenchymal stem cells. This combination has shown enhanced therapeutic efficacy and potential as a treatment option.

For moderate to severe knee osteoarthritis with inflammation, injections of umbilical cord–derived mesenchymal stem cells appear safe and effective. You may see clinical improvement by the end of follow-up. Patients with moderate to severe pain often show particular improvement.

Other approaches, such as bone marrow aspirate concentrate, have conflicting results. It is not possible to say if this is superior to other orthobiologic treatments at this time. Research also explores mobilizing your own body’s stem cells or using exosomes. These findings provide a theoretical rationale for future therapies.

Be aware that there is a significant risk of reporting bias in current trials. Abstracts of these trials often show more positive results than the main text reports. This means you should manage your expectations carefully. Outcomes vary, and the evidence is not yet strong enough to guarantee success. Your surgeon will help you weigh these uncertainties against your specific needs.

Reviewed by Kieran Hirpara · 13 June 2026.

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Talk to your treating clinician for advice specific to you.

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Evidence & references

Overview

  • There is insufficient evidence to recommend stem cell injections in clinical practice for osteoarthritis of the knee at this time [1].
  • Stem cell injections for osteoarthritis of the knee should continue to be studied in rigorous trials [1].
  • Mesenchymal stem cell injections represent a growing area of research in traumatology and orthopaedics [2].
  • There is a significant risk of reporting bias in randomized controlled trials and clinical trials of mesenchymal stromal cells for the treatment of knee osteoarthritis, with abstracts showing a significantly higher proportion of significant P values compared to main texts [9].
  • The superiority of bone marrow aspirate concentrate over other orthobiologic treatments for knee osteoarthritis cannot be assessed given the conflicting results presently available [6].
  • Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [5].
  • The application of mesenchymal stem cells in clinical practice should be guided by the pathophysiology of the target disease [5].
  • The application of mesenchymal stem cells in clinical practice should follow regulatory frameworks to ensure safe and effective use [5].
  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis, with the best effects observed on days 7 and 14 after anterior cruciate ligament transection in a rat model [3].
  • The combination of adipose-derived mesenchymal stem cells and platelet-rich plasma demonstrated enhanced therapeutic efficacy for the treatment of osteoarthritis [4].
  • Intra-articular injection of umbilical cord-derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis [7].
  • Treatment with umbilical cord-derived mesenchymal stem cells showed clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • Endogenous mesenchymal stromal cells can be pharmacologically mobilized into peripheral blood and recruited to the site of rotator cuff repair via local delivery of MCP-1 [8].
  • Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [10].
  • Findings regarding mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes provide a theoretical rationale for the development of exosome-based therapeutic strategies against osteoarthritis [10].
  • These findings identify promising therapeutic targets for the development of exosome-based therapeutic strategies against osteoarthritis [10].

How It Works

  • There is insufficient evidence to recommend stem cell injections in clinical practice at this time [1].
  • Stem cell injections should continue to be studied in rigorous trials [1].
  • Mesenchymal stem cell (MSC) injections represent a growing area of research in traumatology and orthopaedics [2].
  • MSC application in clinical practice should be guided by the pathophysiology of the target disease [5].
  • MSC application in clinical practice should follow regulatory frameworks to ensure safe and effective use [5].
  • The superiority of bone marrow aspirate concentrate (BMAC) over other orthobiologic treatments cannot be assessed given conflicting results [6].
  • Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) is a viable therapeutic option for knee osteoarthritis (KOA) combined with synovitis [7].
  • UC-MSC treatment shows clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • The combination of platelet-rich plasma (PRP) and adipose-derived stem cells (ADSCs) demonstrates enhanced therapeutic efficacy for osteoarthritis [4].
  • Endogenous MSCs can be pharmacologically mobilized into peripheral blood [8].
  • Endogenous MSCs can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [8].
  • MSC-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [10].
  • Local delivery of MSC-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhances tendon regeneration in a rat model of collagenase-induced tendinopathy [11].
  • Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [12].
  • Adipose-derived stem cell (ASC) interactions with the immune system are complex [13].
  • ASC secretome may be a well-tolerated treatment for osteoarthritis, though further studies are needed to determine its potential therapeutic benefits [13].
  • Hypoxic MSCs might exert therapeutic effects mediated by stimulating TGF-β [16].
  • Hypoxic MSCs promote the expression of COL II [16].
  • Hypoxic MSCs inhibit the expression of COL X [16].

What the Evidence Shows

  • There is insufficient evidence to recommend stem cell injections in clinical practice for osteoarthritis of the knee at this time [1].
  • Stem cell injections for osteoarthritis of the knee should continue to be studied in rigorous trials [1].
  • Mesenchymal stem cell injections represent a growing area of research in traumatology and orthopaedics [2].
  • There is a significant risk of reporting bias in randomized controlled trials and clinical trials of mesenchymal stromal cells for the treatment of knee osteoarthritis, with abstracts showing a significantly higher proportion of significant P values compared to main texts [9].
  • Spin bias was present in most mesenchymal stromal cell-related trials for knee osteoarthritis, with a higher frequency among trials that utilized adipose-derived mesenchymal stem cells [14].
  • The superiority of bone marrow aspirate concentrate over other orthobiologic treatments for knee osteoarthritis cannot be assessed given the conflicting results presently available [6].
  • Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations, but their application should be guided by the pathophysiology of the target disease and follow regulatory frameworks to ensure safe and effective use [5].
  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis, with the best effects observed on days 7 and 14 after anterior cruciate ligament transection in a rat model [3].
  • The combination of platelet-rich plasma and adipose-derived stem cells demonstrated enhanced therapeutic efficacy for the treatment of osteoarthritis [4].
  • Treatment with umbilical cord-derived mesenchymal stem cells was shown to be a viable therapeutic option for knee osteoarthritis combined with synovitis, showing clinical improvement at the end of follow-up, especially in those with moderate to severe pain [7].
  • Endogenous mesenchymal stromal cells can be pharmacologically mobilized into peripheral blood and recruited to the site of rotator cuff repair via local delivery of MCP-1 [8].
  • Local delivery of mesenchymal stem cell-derived extracellular vesicles embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [11].
  • Local application of bone marrow aspirate concentrate without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [12].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate appeared to be safe, and clinical outcomes were favorable up to 2 years postoperation despite having no quantifiable effect on graft maturation [15].
  • Arthroscopic surgical repair combined with mesenchymal stem cell augmentation reported better structural outcomes compared to isolated surgical repair for rotator cuff tears [17].

Practical Considerations

  • There is insufficient evidence to recommend stem cell injections in clinical practice at this time [1].
  • Stem cell injections should continue to be studied in rigorous trials [1].
  • Mesenchymal stem cell injections represent a growing area of research in traumatology and orthopaedics [2].
  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis [3].
  • The best effects of stem cell treatment for posttraumatic osteoarthritis are observed on days 7 and 14 after anterior cruciate ligament transection [3].
  • The combination of platelet-rich plasma and adipose-derived mesenchymal stem cells demonstrated enhanced therapeutic efficacy for osteoarthritis [4].
  • Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [5].
  • The application of mesenchymal stem cells should be guided by the pathophysiology of the target disease [5].
  • The application of mesenchymal stem cells should follow regulatory frameworks to ensure safe and effective use [5].
  • The superiority of bone marrow aspirate concentrate over other orthobiologic treatments cannot be assessed given the conflicting results presently available [6].
  • Treatment with umbilical cord-derived mesenchymal stem cells is a viable therapeutic option for knee osteoarthritis combined with synovitis [7].
  • Umbilical cord-derived mesenchymal stem cell treatment showed clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • There is a significant risk of reporting bias in randomized controlled trials and clinical trials of mesenchymal stromal cells for the treatment of knee osteoarthritis [9].
  • Abstracts of mesenchymal stromal cell trials for knee osteoarthritis show a significantly higher proportion of significant P values compared to main texts [9].
  • Spin bias was present in most mesenchymal stromal cell-related trials for knee osteoarthritis [14].
  • Spin bias had a higher frequency among trials that utilized adipose-derived mesenchymal stem cells [14].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate appeared to be safe [15].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate produced favorable clinical outcomes up to 2 years postoperation [15].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate had no quantifiable effect on graft maturation [15].
  • Adipose-derived stem cell interactions with the immune system are complex [13].
  • The secretome of adipose-derived stem cells may be a well-tolerated treatment for osteoarthritis [13].
  • Further studies are needed to determine the potential therapeutic benefits of adipose-derived stem cell secretome [13].

Key Evidence

  • [L1] There is insufficient evidence to recommend stem cell injections in clinical practice at this time, but they should continue to be studied in rigorous trials. [1] (10.1097/corr.0000000000003593)
  • [L2] MSC injections represent a growing area of research in traumatology and orthopaedics. [2] (10.1186/s12891-025-09123-8)
  • [L5] The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for PTOA, with the best effects observed on days 7 and 14 after ACLT. [3] (10.1177/03635465251326499)
  • [L5] The combination of PRP and ADSCs demonstrated enhanced therapeutic efficacy, suggesting its potential as a treatment option for OA. [4] (10.1186/s13018-024-05396-2)
  • [L5] Mesenchymal stem cells (MSCs) have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations, but their application should be guided by the pathophysiology of the target disease and follow regulatory frameworks to ensure safe and effective use. [5] (10.1530/eor-2026-0056)
  • [L2] However, the superiority of BMAC over other orthobiologic treatments cannot be assessed given the conflicting results presently available. [6] (10.1186/s13018-025-06509-1)
  • [L1] Treatment with UC-MSCs was shown to be a viable therapeutic option for KOA combined with synovitis, showing clinical improvement at the end of follow-up, especially in those with moderate to severe pain. [7] (10.1186/s12891-025-09440-y)
  • [L5] Endogenous MSCs can be pharmacologically mobilized into peripheral blood and recruited to the site of rotator cuff repair via local delivery of MCP-1. [8] (10.1177/03635465251341439)
  • [L2] The study highlights a significant risk of reporting bias in RCTs and CTs of MSCs for the treatment of knee OA, with abstracts showing a significantly higher proportion of significant P values compared to main texts. [9] (10.1177/23259671251374306)
  • [L5] These findings provide a theoretical rationale and identify promising therapeutic targets for the development of exosome-based therapeutic strategies against OA. [10] (10.1186/s13018-026-06765-9)
  • [L5] Local delivery of MSC-EVs embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy. [11] (10.1177/03635465261421555)
  • [L5] Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing. [12] (10.1177/03635465241313124)
  • [L5] This study highlights the complexity of ASC interactions with the immune system, while secretome may be a well-tolerated treatment, further studies are needed to determine its potential therapeutic benefits. [13] (10.1186/s12891-025-08642-8)
  • [L2] Spin bias was present in most MSC-related trials for knee osteoarthritis, with a higher frequency among those that utilized adipose-derived MSCs. [14] (10.1177/03635465241274155)
  • [L4] This case series demonstrated that augmenting hamstring allograft ACL reconstruction with an amnion collagen matrix and injecting BMAC appeared to be safe, and clinical outcomes were favorable up to 2 years postoperation despite having no quantifiable effect on graft maturation. [15] (10.1016/j.asmr.2025.101209)
  • [L5] Hypoxic MSCs might exert therapeutic effects mediated by stimulating TGF-β and subsequently promote and inhibit the expressions of COL II and COL X respectively. [16] (10.1186/s13018-025-06184-2)
  • [L1] Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. [17] (10.1016/j.jseint.2025.03.017)

References

[1] Cochrane in CORR ®: Stem Cell Injections for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003593 [2] Mesenchymal stem cells injections in traumatology and orthopaedics: common practice or still a promising area with many uncertainties?. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09123-8 [3] Days 7 to 14 May Represent an Optimal Window for Stem Cell–Based Treatment in a Rat Model of Anterior Cruciate Ligament Transection–Induced Posttraumatic Osteoarthritis. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251326499 [4] Adipose-derived mesenchymal stem cells combined with platelet-rich plasma are superior options for the treatment of osteoarthritis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-024-05396-2 [5] Clinical application of mesenchymal stem cells in orthopaedics and traumatology in daily practice. EFORT Open Reviews. 2026. DOI: 10.1530/eor-2026-0056 [6] Progress in the clinical use of bone marrow aspirate concentrate for knee osteoarthritis: an expert opinion. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06509-1 [7] Intra-articular injection of umbilical cord–derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis: a double‑blinded and randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09440-y [8] Pharmacologic Mobilization and Chemokine-Directed Recruitment of Mesenchymal Stromal Cells to the Surgically Repaired Rotator Cuff. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251341439 [9] Analysis of P Values in the Abstract Compared With the Main Text of Randomized Controlled Trials and Clinical Trials of Mesenchymal Stromal Cells for the Treatment of Knee Osteoarthritis. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251374306 [10] Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06765-9 [11] Regenerative Effect of Injectable Collagen Loaded With Mesenchymal Stem Cell–Derived Extracellular Vesicles in a Collagenase-Induced Tendinopathy Rat Model. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261421555 [12] Bone Marrow Aspirate Concentrate Combined With an Appropriate Carrier Effectively Promotes Bone-Tendon Interface Healing in a Rabbit Model of Chronic Rotator Cuff Tear. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241313124 [13] Impact of adipose-derived mesenchymal stem cells and their secretome on osteoarthritis in a rat model. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08642-8 [14] Evaluation of Spin in Clinical Trials of Mesenchymal Stromal Cells for the Treatment of Knee Osteoarthritis: A Systematic Review. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241274155 [15] Augmenting an Allograft for Anterior Cruciate Ligament Reconstruction With a Collagen Matrix and Bone Marrow Aspirate Concentrate Injection Appears Safe and Produces Favorable Clinical Outcomes at 2‐Year Follow‐Up. Arthroscopy, Sports Medicine, and Rehabilitation. 2025. DOI: 10.1016/j.asmr.2025.101209 [16] Roles of TGF-β in the therapeutic potential of hypoxic mesenchymal stem cells for treating osteoarthritis in a Rabbit model. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06184-2 [17] Combined arthroscopic rotator cuff repair with mesenchymal stem cell augmentation shows similar functional outcomes but a higher structural integrity rate compared with isolated repair: a meta-analysis of comparative studies. JSES International. 2025. DOI: 10.1016/j.jseint.2025.03.017

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b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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