Method Categorization of Stem Cell Therapy for Degenerative Osteoarthritis of the Knee: A Review

Abstract

Current clinical applications of mesenchymal stem cell therapy for osteoarthritis lack consistency because there are no established criteria for clinical processes. We aimed to systematically organize stem cell treatment methods by reviewing the literature. The treatment methods used in 27 clinical trials were examined and reviewed. The clinical processes were separated into seven categories: cell donor, cell source, cell preparation, delivery methods, lesion preparation, concomitant procedures, and evaluation. Stem cell donors were sub-classified as autologous and allogeneic, and stem cell sources included bone marrow, adipose tissue, peripheral blood, synovium, placenta, and umbilical cord. Mesenchymal stem cells can be prepared by the expansion or isolation process and attached directly to cartilage defects using matrices or injected into joints under arthroscopic observation. The lesion preparation category can be divided into three subcategories: chondroplasty, microfracture, and subchondral drilling. The concomitant procedure category describes adjuvant surgery, such as high tibial osteotomy. Classification codes were assigned for each subcategory to provide a useful and convenient method for organizing documents associated with stem cell treatment. This classification system will help researchers choose more unified treatment methods, which will facilitate the efficient comparison and verification of future clinical outcomes of stem cell therapy for osteoarthritis.

Connection between Mesenchymal Stem Cells Therapy and Osteoclasts in Osteoarthritis

“…Indeed, many factors, such as the storage temperature of the MSCs and preservation agents employed, could also affect the effectiveness of this cell therapy [135,136]. For these reasons, we are still far from knowing the most optimal conditions for the use of MSCs as a therapeutic tool in preclinical and clinical trials in OA [137,138]. Despite numerous existing studies, no significant clinical effects of these cells on OA have been determined, although some authors describe an improvement in the observation of the clinical image and histological results after the infiltration of MSCs in the knee [11,139].…”

“…Curiously, the number of reviews regarding the beneficial potential of MSCs and small EVs in OA pathology has increased very recently [137,141,182,183]. These reviews indirectly suggest that there may be a modulatory action of MSCs or of MSC-derived EVs on OCL differentiation in osteoarticular pathologies.…”

Scanning electron microscopy analysis of synovial and adipose mesenchymal stem cells adhering to cartilage

“…MSCs derived from adipose tissues are increasingly used for intra-articular injections in the treatment of knee osteoarthritis [ 15 ], primarily because adipose tissues can be harvested from subcutaneous fat and are readily obtainable from elderly patients. However, the ultrastructure of adipose MSCs and their role in adhesion to cartilage tissue remain unclear.…”

Application of hydrogel scaffolds as a cell substrate for cartilage tissue regeneration

“…Для лечения тяжёлых повреждений хряща, например при остео артрите коленного сустава, во всём мире используют хирургические методы: артроскопические операции, остеотомию коленного сустава и тотальное эндопротезирование. Однако искусственные суставы имеют ограниченный срок службы и часто требуют дополнительного хирургического вмешательства при ревизии эндопротеза [1]. По этой причине к настоящему времени предложено несколько стратегий активации репараторных процессов для восстановления суставного хряща на этапе его очаговых дефектов, которые выявляются во время артроскопии почти в 20% случаев [2].…”