Nano- and microcarrier technology significantly improves mesenchymal stem cell (MSC) viability and targeted delivery for osteoarthritis treatment, addressing the critical limitation of poor cell survival that has hampered previous therapeutic attempts. These biomaterial-based carriers encapsulate MSCs, enhancing their retention at injury sites while maintaining their cartilage-regenerating and anti-inflammatory properties. The advancement represents a crucial step forward in regenerative medicine for joint degeneration. Osteoarthritis affects over 500 million people globally, with current treatments largely limited to symptom management rather than tissue repair. Traditional MSC therapy showed promise but suffered from rapid cell death and poor localization to damaged cartilage. The carrier technology effectively creates a protective microenvironment that sustains cell function while enabling precise delivery. This approach could transform treatment for aging adults, who experience increasing cartilage breakdown due to accumulated wear and declining repair capacity. However, the review nature limits assessment of specific clinical efficacy data. The technology remains in development phases, requiring extensive human trials to validate safety and long-term outcomes before widespread clinical adoption.