Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Abstract

Purpose Mesenchymal stem cells (MSCs) present a valuable treatment option for knee osteoarthritis with promising results. The purpose of the present study was to systematically review the clinical and functional outcomes following mesenchymal stem cell application focusing on early to moderate knee osteoarthritis. Methods A systematic search was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, Scopus, Web of Science, and Cochrane Library databases. All Studies published between 2017 and March 2023 on patients treated with single mesenchymal stem cell injection for Kellgren-Lawrence grade I—III knee osteoarthritis reported on clinical and functional outcomes were included. Results Twelve articles comprising 539 patients and 576 knees treated with a single intraarticular injection of MSCs for knee osteoarthritis were included in the current systematic review. In eligible studies, the reported outcomes were improved concerning patient-reported outcomes measures, knee function, pain relief, and quality of patient's life. Conclusion Based on high-level evidence studies, single intraarticular injection of MSCs is a safe, reliable, and effective treatment option for Kellgren-Lawrence grade I—III knee osteoarthritis. However, the lack of homogeneity in the included studies and the variance in MSCs sources and preparations should be noted. Level of evidence III.

Hyaluronic acid, platelet-rich plasma, bone marrow aspirate concentrate, the stromal vascular fraction, or mesenchymal stem cells: which is the best candidate for treating knee osteoarthritis?

“…They concluded that MSC injection is effective for treating knee OA, and the curative effect should be maintained for no less than 12 months, during which the WOMAC pain score, VAS score, WOMAC stiffness score, and WOMAC physical function improve 27 . In another review, 12 articles comprising 539 patients and 576 knees treated with a single intraarticular injection of MSCs for knee OA were analyzed by Kyriakidis et al (2023) 28 , who reported that MSC injection is a safe and effective treatment for K-L grade I-III knee OA. Interestingly, a triple-blinded, placebo-controlled, randomized trial compared the treatment efficacy of allogeneic MSCs (from adipose tissue) to that of normal saline (control group) and confirmed that allogeneic MSC injection is safe and significantly improves treatment efficacy 29 .…”

Why Kinematic Alignment Makes Little Sense in Valgus Osteoarthritis of the Knee: A Narrative Review

“…In the early stages of valgus osteoarthritis, conservative treatment is the preferred treatment and includes exercise, weight loss, pharmacological treatments (NSAIDs) and unloader braces [ 8 ]. In addition, there appears to be a growing interest in alternative therapies, including acupuncture, PRP injections, stem cell injections and dry needling [ 9 , 10 , 11 , 12 ]. A recent systematic review and meta-analysis showed very low-quality evidence for a possible positive short-term effect on osteoarthritis concerning pain intensity and improving physical function [ 13 ].…”