Systematic evidence analysis of symptom modification in hip osteoarthritis following MSC-based interventions

Mesenchymal stromal/stem cell (MSC)-based interventions are increasingly used for hip osteoarthritis (HOA), although the products and supporting clinical evidence are heterogeneous. This systematic review evaluated symptom modification, safety, and methodological quality.

PubMed/MEDLINE was searched on 1 August 2024 using MeSH and free-text terms. One author performed study screening, data extraction, and risk of bias assessment using the Downs and Black checklist and 9 studies comprising 307 patients were included. Because of clinical and methodological heterogeneity, results were synthesized descriptively; weighted outcome means were calculated only from studies reporting compatible baseline and follow-up values.

The interventions included culture-expanded MSCs, bone marrow concentrate, stromal vascular fraction, and micro-fragmented adipose tissue, with or without platelet-rich plasma. In contributing cohorts, VAS pain scores decreased from 6.7 to 3.7 (n = 58), WOMAC scores decreased from 35.4 to 18.5 (n = 49), and Harris hip scores increased from 40.8 to 62.8 (n = 76). These findings represent within-group changes rather than comparative treatment effects. Serious adverse events were uncommon, but reporting was incomplete and follow-up was generally limited.

The use of MSC-based interventions was associated with encouraging short-term within-group improvements in pain and function; however, small samples, product heterogeneity, predominantly uncontrolled designs and limited safety reporting preclude conclusions regarding efficacy or structural disease modification. Adequately powered randomized controlled trials with standardized products and outcomes are required.