Stem cell application for osteoarthritis in the knee joint: A minireview

Abstract

Knee osteoarthritis is a chronic, indolent disease that will affect an ever increasing number of patients, especially the elderly and the obese. It is characterized by degeneration of the cartilage substance inside the knee which leads to pain, stiffness and tenderness. By some estimations in 2030, only in the United States, this medical condition will burden 67 million people. While conventional treatments like physiotherapy or drugs offer temporary relief of clinical symptoms, restoration of normal cartilage function has been difficult to achieve. Moreover, in severe cases of knee osteoarthritis total knee replacement may be required. Total knee replacements come together with high effort and costs and are not always successful. The aim of this review is to outline the latest advances in stem cell therapy for knee osteoarthritis as well as highlight some of the advantages of stem cell therapy over traditional approaches aimed at restoration of cartilage function in the knee. In addition to the latest advances in the field, challenges associated with stem cell therapy regarding knee cartilage regeneration and chondrogenesis in vitro and in vivo are also outlined and analyzed. Furthermore, based on their critical assessment of the present academic literature the authors of this review share their vision about the future of stem cell applications in the treatment of knee osteoarthritis.

A new treatment for knee osteoarthritis: Clinical evidence for the efficacy of Arthrokinex™ autologous conditioned serum

“…21 Currently, the capacity of MSCs to provide clinical benefits is unclear. 22 Our novel autologous conditioning processing, Arthrokinex TM (ACS), and subsequent standardized protocol, was developed following the success of treatment strategies such as Orthokine and Arthrex that induced IL-1-Ra from whole blood. 10,11 Arthrokinex TM (ACS) offers an interventional orthopedic treatment plan at the molecular level and it incorporates the inhibition of IL-1b through the rapid induction of IL-1-Ra.…”

Effects of intra-articular injection of mesenchymal stem cells associated with platelet-rich plasma in a rabbit model of osteoarthritis

“…Furthermore, regenerated cartilage is very fragile, and can be damaged with even a low level of stress to the joints (Gupta et al, 2012). Thus, selfregeneration of cartilage is not only a slow process, but also produces cartilage tissues that are not stable enough to resist intensive use (Uth and Trifonov, 2014). Kim et al (2015) reported that it is possible to artificially stimulate the regeneration process by delivering MSCs to knee joints affected with OA.…”

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

“…The basic pathophysiological characteristic of knee OA is loss of articular cartilage which is linked to biomechanical and biochemical changes in the cartilage of the knee joint such as, diminished ability to withstand normal mechanical stresses, limited supply of nutrients and oxygen, inadequate synthesis of extracellular matrix components, increased synthesis of tissue-destructive proteinases (matrix metalloproteinases and aggrecanase) and overall apoptosis of chondrocytes. 8,9,20,21 Although, recently synovial inflammation has been reported as a factor limiting cartilage repair. 22 Articular cartilage exhibits little or no ability for self-repair, because of the low mitotic ability of chondrocytes, and lack of blood, lymphatic or nerve supply, resulting in progressive tissue loss and dysfunction and presenting as a potential challenge for orthopaedic surgeons.…”

“…6,7 Osteoarthritis of the knee is the most common chronic condition affecting all races, gender and ages, but known to be the most common in elderly and obese people. 8,9 The knee acts as a conduit for transferring body weight essential for normal human mobility and the menisci is known to maintain the normal function of the knee, distribute load, lubricate the joint and provide joint stability. Injury to the meniscus from ageing cartilage, repetitive activity or trauma results in pain, limits movement and can accelerate the occurrence and development of OA.…”