Mesenchymal stem cells - a promising strategy for treating knee osteoarthritis

Area of Science:

• Orthopedics
• Regenerative Medicine
• Cell Therapy

Background:

• Knee osteoarthritis (OA) is a degenerative joint disease with limited effective treatments.
• Mesenchymal stem cells (MSCs) possess cartilage regeneration potential, suggesting therapeutic applications for OA.

Purpose of the Study:

• To evaluate the efficacy and safety of mesenchymal stem cells (MSCs) for treating knee osteoarthritis (OA).
• To assess the impact of MSC therapy on pain, function, and structural changes in knee OA patients.

Main Methods:

• A systematic literature search was conducted on PubMed, Embase, and Cochrane Library up to June 2019.
• Seven randomized controlled trials (RCTs) involving 256 patients treated with MSCs for knee OA were included in a meta-analysis.
• Pain (VAS), function (WOMAC), and MRI scores (WORMS) were primary outcome measures; subgroup analyses considered cell dose and source.

Main Results:

• MSC treatment significantly improved visual analogue scale (VAS) pain scores and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.
• Patients receiving lower doses of MSCs (less than 30 million cells) demonstrated greater improvements in VAS and WOMAC scores.
• Adipose and umbilical cord-derived MSCs showed more favorable outcomes for pain reduction compared to bone marrow-derived MSCs.

Conclusions:

• Mesenchymal stem cell (MSC)-based therapy is a safe and potentially effective treatment for knee osteoarthritis (OA), improving pain and knee function.
• Optimal outcomes may be achieved with lower cell doses (around 25 million) and the use of adipose-derived stem cells.
• Further research is necessary to fully elucidate the long-term benefits and optimal protocols for MSC therapy in knee OA.