Avoidance of total knee arthroplasty in early osteoarthritis of the knee with intra-articular implantation of autologous activated peripheral blood stem cells versus hyaluronic acid: A randomized controlled trial with differential effects of growth factor addition

Osteoarthritis and stem cell therapy in humans: a systematic review

“…Garay-Mendoza et al 29 reported similar improvement compared to acetaminophen placebo. Turajane et al 93 also found significantly better WOMAC scores in PBSC-treated groups (WOMAC ¼ 52 or 75) compared to the HA-placebo group (WOMAC ¼ 126.8) at 12 months (P < 0.001). Two studies recorded improved WOMAC scores, but not when compared to placebo groups 89,94 , and three studies exhibited improved WOMAC but lacked a placebo to compare to 13,30,90 .…”

“…Amongst the levels I and II evidence, three studies used radiographic guidance 88,92,97 , one used arthroscopic guidance 85 , one was implanted in an open procedure 95 , while nine reported neither. Three studies 93,95,96 were completed in conjunction with a surgical procedure. There is also variability in adjuvants, but the most common used are PRP (n ¼ 20), platelet lysate (n ¼ 8), and hyaluronic acid (n ¼ 10).…”

“…x Based on total number of joints of those studies that reported gender (6 studies did not report gender by joint) 72,81,85,95,82 . All level I and II studies that measured WOMAC also saw improvements upon follow-up 13,29,30,87,89,90,93,94 . Lamo-Espinosa et al 87 showed improved WOMAC scores in high-dose BMSCtreated patients than in the HA placebo group (P < 0.01).…”

“…This study employed three injections and compared groups that received microdriling, PBSC, growth factor addition, and HA (group 1) vs PBSC, PRP, HA (group 2) vs HA alone (group 3). The mean follow-up length of time for all studies was 14 ± 7 mo (Range 6 to 24) 93 .…”

“…Other measures less commonly used are noted in Table V including improvements in ICOAP 89,92 , joint flexion and extension measurements 87 , need for surgical intervention 93 , Lequesne score 94 , SF-12/36 life quality questionnaire 94,97 , -100-to-þ100 pain relief score 88 , KSS 13,90 , KOOS 90,91,97 , Lysholm score 30,91,96 , Kanamiya grading 91 , Modified Outerbridge classification 30 , activity level 92 , HSS Knee Rating Scale 95 , and second look arthroscopy and histology 95 .…”