Intra-Articular Injection of Bone Marrow-Derived Mesenchymal Stem Cells Leading to Better Clinical Outcomes without Difference in MRI Outcomes from Baseline in Patients with Knee Osteoarthritis

Abstract

PurposeBone marrow (BM) is frequently used as a source of mesenchymal stem cells (MSCs) because they have a high potential for differentiation. However, it is unclear whether BM-derived MSCs lead to better clinical and magnetic resonance imaging (MRI) outcomes postoperatively.Materials and MethodsThis meta-analysis compared the clinical and MRI outcomes in patients with knee osteoarthritis (OA) treated with BM-derived MSCs. Eight studies comparing the clinical and MRI outcomes assessed with various measurement tools in patients with knee OA treated with BM-derived MSCs were included.ResultsThe range of motion (95% confidence interval [CI], −13.05 to 4.24; p=0.32) and MRI outcomes (95% CI, −0.16 to 1.40; p=0.12) did not differ significantly between the baseline and final follow-up. In contrast, pain (95% CI, 0.89 to 1.87; p<0.001) and functional outcomes (95% CI, 0.70 to 2.07; p<0.001) were significantly improved at the final follow-up when compared to the baseline.ConclusionsThis meta-analysis found no significant difference in the tested range of motion and MRI outcomes between the baseline and the final follow-up in patients treated with BM-derived MSCs, whereas significant functional improvement and pain relief were noted when compared with the baseline. Thus, BM-derived MSCs appear to be a viable alternative for patients with knee OA, although long-term and high-quality randomized controlled trials are needed to confirm the clinical benefits.

Exosomes: roles and therapeutic potential in osteoarthritis

“…[158][159][160] Clinical trials of intra-articular injection of MSCs into the knee with OA have exhibited reliable safety and feasibility, 161,162 while this approach could ameliorate the knee society clinical rating system (KSS) and OA outcome score 163,164 and partially alleviate knee pain. [165][166][167][168] However, the detailed mechanisms for this and other stem cell-based OA treatments have not been well clarified. An increasing number of studies have suggested that the therapeutic effects of stem cells are mainly dependent on the paracrine function of stem cells, including the secretion of EVs.…”

Hybrid Bioprinting of Chondrogenically Induced Human Mesenchymal Stem Cell Spheroids

“…It has been demonstrated that gelMA supports cartilage-like matrix production when a suspension of single chondrocytes or mesenchymal stem cells (MSC) were embedded (Hu et al, 2009;Schuurman et al, 2013;Mouser et al, 2018;Pahoff et al, 2019). Recently, there has been an increased interest in the use of adult MSC in cartilage regeneration because of their multipotency and ability to differentiate into chondrogenic lineages after expansion in vitro and intra-articular injections of MSC have been performed to reduce osteoarthritic pain or induce cartilage repair (Jo et al, 2014;Shin et al, 2018). The use of MSC would also eliminate the need for harvesting surgery within the damaged knee-joint or donor site.…”

Autologous, micro-fragmented adipose tissue as a treatment for chronic shoulder pain in a wheelchair using individual with spinal cord injury: a case report

“…However, the degree of tendinosis seen in the supraspinatus, infraspinatus, and subscapularis remained unchanged at 12 months. Similar outcomes have been seen with individuals undergoing regenerative procedures in the past with improvement in pain and function without significant structural changes on diagnostic imaging [19][20][21]. Furthermore, studies have shown that structural changes seen on MRI that may be suggestive of pathology can be seen in both symptomatic and asymptomatic patients [22].…”