Stem Cell Therapy for Articular Cartilage Repair: Review of the Entity of Cell Populations Used and the Result of the Clinical Application of Each Entity

Abstract

Limited evidence is available regarding clinical benefit of stem cell therapy for articular cartilage repair. Because the literature contains substantial errors in describing the therapeutic cells used, researchers need to be alert and observant of proper terms, especially regarding whether the cells used were stem cells or cell populations containing a small portion of stem cells, to prevent confusion in understanding the results of a given stem cell-based therapy.

Editorial Commentary: Considering Clinical Application of Bone Marrow Aspirate Concentrate for Restoration of Cartilage Defects in the Knee? Is It a Kind of Stem Cell Therapy?

“…Unlike "cultured stem cells," which are under strict regulation by regulatory authorities such as the US Food and Drug Administration for clinical application in most countries in the world, BMAC is categorized as "minimally manipulated cells" that are available for clinical application on the same day under the clinicians' responsibility in many countries. 4 Unlike the culture-expanded bone marrowederived MSCs, BMAC has a very low concentration of MSCs (0.001% to 0.01%). 2 The study by Cavinatto et al 1 confirmed that the cells present in BMAC did not meet the criteria to be characterized as MSCs according to the International Society for Cellular Therapy.…”

“…Recently, the nomenclature of the entity of cells used in stem cell therapy for the treatment of cartilage lesions has been emphasized to properly assess the efficacy and safety of various stem cell therapies. [4][5][6] The article by Cavinatto et al 1 clearly showed that the role of BMAC for the treatment of focal chondral lesions of the knee is still inconclusive based on the currently available data from translational and clinical studies. Although BMAC showed favorable outcomes for focal chondral lesions in some clinical studies, animal studies showed disparate outcomes.…”

“…We believe the efficacy of various stem cell therapies regarding cartilage restoration remains unclear mostly because of the heterogeneity and inconsistency of the entity of cells used for the treatments. 4,5 Constant effort is needed to prove the therapeutic potential of various novel therapeutic options such as BMAC or stem cell therapy under correct terminology for cartilage restoration before routine clinical application.…”

Die Geschichte der operativen Arthrosetherapie

“…Hierzu sind die knorpelregenerativen Verfahren einschließlich der osteochondralen Transplantation, der autologen Chondrozytentransplantation und der Umstellungsosteotomien ein wichtiges Behandlungskonzept, um die Zahl der weiter zunehmenden endoprothetischen Eingriffe besonders auch in relativ jungen Jahren zu reduzieren. In Zukunft wird man möglicherweise neben den oben beschriebenen Verfahren zur Behandlung praearthrotischer und früharthrotischer Gelenke durch den Einsatz von autologen oder allogenen Stammzellaufbereitungen aus der Reihe des Binde-und Stützgewebes der Arthroseentwicklung noch besser entgegentreten können [58,59].…”

In vitro study on chondrogenic differentiation of human adipose-derived stem cells on treated bovine pericardium

“…Depending on the autologous cartilage grafts, this solution significantly helps increase a large amount of chondrocytes at the cartilage damage site to facilitate the healing and repair process (Marlovits et al, 2006). Additionally, adipose tissue is known as the most suitable stem cell supplier as it can be collected easily from a liposuction procedure, which is considered to have the fewest ethical implications and increased donation (Miana and González, 2018;Park et al, 2018). Human adipose-derived stem cells (hADSCs) can be harvested in large amounts using established protocols.…”