Stem cells in articular cartilage regeneration.

Area of Science:

• Orthopedics and Regenerative Medicine
• Cell Therapy and Tissue Engineering
• Biomedical Research

Background:

• Mesenchymal stem cells (MSCs) are explored for treating articular defects and early osteoarthritis (OA).
• Clinical application of MSCs faces controversy regarding their efficacy and limitations.
• A systematic review is needed to consolidate evidence on MSC treatment strategies for cartilage lesions and OA.

Purpose of the Study:

• To systematically review clinical studies on Mesenchymal stem cells (MSCs) treatment strategies.
• To summarize current evidence on the efficacy of MSCs for cartilage lesions and osteoarthritis (OA).
• To identify factors influencing MSC therapy outcomes and optimal delivery methods.

Main Methods:

• Systematic review of 60 selected studies (7 randomized, 13 comparative, 31 case series, 9 case reports).
• Analysis of studies based on administration method (injective vs. surgical implantation) and cell source (BMSCs, ADSCs, BMC, PBSCs, SDSCs).
• Evaluation of reported clinical outcomes, adverse events, and influencing factors.

Main Results:

• No major adverse events were reported for MSC treatment or cell harvest.
• Most studies reported clinical benefits of MSC therapies, supported by clinical, MRI, and macroscopic findings, though histologic results were mixed.
• Younger age, lower BMI, smaller lesion size, and earlier OA stages correlated with better outcomes.
• Cultured MSCs were often administered via intra-articular injection, while cell concentrates favored surgical implantation.

Conclusions:

• While MSC therapies show promise for cartilage repair and OA, robust clinical data from high-level studies are required for confirmation.
• Further research should focus on optimizing cell sources, manipulation, delivery techniques, and identifying ideal indications based on pathology and disease phase.
• Standardized, well-designed prospective studies are essential to establish definitive evidence for MSC efficacy in orthopedic applications.