Clinical Efficacy and Safety of Stem Cell Therapy for Knee Osteoarthritis: A Meta-analysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2020 Mar 17

PMID 32176071

Citations 15

Authors

Rui Huang

Wei Li

Ying Zhao

Fan Yang

Meng Xu

Affiliations

Soon will be listed here.

Abstract

Background: We performed a meta-analysis of the efficacy and safety of stem cell therapy as a clinical treatment of knee osteoarthritis. This meta-analysis is expected to provide evidence of the efficacy of stem cell therapy, which is currently controversial, as a conservative treatment for knee osteoarthritis.

Methods: An online search for relevant articles was conducted in the PubMed, EMBASE, and Cochrane Library databases. The search terms were "stem cells" and "osteoarthritis." We conducted a quality assessment of the included articles and extracted the following indicators: Visual Analogue Scale (VAS) score, Subjective International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities (WOMAC) subscales, and adverse events. The RevMan5.3 software was used for determining effect sizes.

Results: Nine randomized controlled trials involving 339 patients were included. VAS score and IKDC score from baseline to 24 months were improved in the stem cell therapy group compared to those in the control group. However, no significant difference was observed between the 2 groups in IKDC score changes from baseline to 6 and 12 months, as well as in WOMAC-Pain, WOMAC-Stiffness, and WOMAC-Physical Function score changes at each visit point.

Conclusion: Stem cell therapy is certainly superior to traditional treatments in the conservative treatment of KOA; it considerably reduces pain with no obvious additional side effects.

Citing Articles

Effects of muscle energy technique along conventional physical therapy after mesenchymal stem cell transplantation in knee osteoarthritis patients.

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Intra-Articular Injection of Stem Cells for the Regeneration of Knee Joint Cartilage: a Therapeutic Option for Knee Osteoarthritis - a Narrative Review.

Lee H, Hossain R, Baek C, Lee C, Hwang S Biomol Ther (Seoul). 2024; 33(1):86-94.

PMID: 39632656 PMC: 11704397. DOI: 10.4062/biomolther.2024.139.

Advanced therapy with mesenchymal stromal cells for knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials.

Tabet C, Pacheco R, Martimbianco A, Riera R, Hernandez A, Bueno D J Orthop Translat. 2024; 48:176-189.

PMID: 39360004 PMC: 11445595. DOI: 10.1016/j.jot.2024.07.012.

Evaluation of the therapeutic potential of infrapatellar fat pad adipose-derived stem cells and their secretome for regenerating knee articular cartilage in a rat model of osteoarthritis.

Dalir S, Meimandi Parizi A, Tanideh N, Kian M, Nowzari F, Iraji A Iran J Vet Res. 2024; 25(1):33-40.

PMID: 39156795 PMC: 11327642. DOI: 10.22099/IJVR.2024.47870.6959.

Seven-Year Longitudinal Study: Clinical Evaluation of Knee Osteoarthritic Patients Treated with Mesenchymal Stem Cells.

Spasovski D, Spasovski V, Bascarevic Z, Stojiljkovic M, Andjelkovic M, Pavlovic S J Clin Med. 2024; 13(13).

PMID: 38999426 PMC: 11242523. DOI: 10.3390/jcm13133861.

References

Wang D, Zhang H, Liang J, Li X, Feng X, Wang H . Allogeneic mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus: 4 years of experience. Cell Transplant. 2014; 22(12):2267-77. PMC: 11849135. DOI: 10.3727/096368911X582769c. View

Murphy J, Dixon K, Beck S, Fabian D, Feldman A, Barry F . Reduced chondrogenic and adipogenic activity of mesenchymal stem cells from patients with advanced osteoarthritis. Arthritis Rheum. 2002; 46(3):704-13. DOI: 10.1002/art.10118. View

Vangsness Jr C, Farr 2nd J, Boyd J, Dellaero D, Mills C, LeRoux-Williams M . Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014; 96(2):90-8. DOI: 10.2106/JBJS.M.00058. View

Lazarus H, Koc O, Devine S, Curtin P, Maziarz R, Holland H . Cotransplantation of HLA-identical sibling culture-expanded mesenchymal stem cells and hematopoietic stem cells in hematologic malignancy patients. Biol Blood Marrow Transplant. 2005; 11(5):389-98. DOI: 10.1016/j.bbmt.2005.02.001. View

Juni P, Altman D, Egger M . Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ. 2001; 323(7303):42-6. PMC: 1120670. DOI: 10.1136/bmj.323.7303.42. View

Krasnokutsky S, Samuels J, Abramson S . Osteoarthritis in 2007. Bull NYU Hosp Jt Dis. 2007; 65(3):222-8. View

Bernardo M, Pagliara D, Locatelli F . Mesenchymal stromal cell therapy: a revolution in Regenerative Medicine?. Bone Marrow Transplant. 2011; 47(2):164-71. DOI: 10.1038/bmt.2011.81. View

Vega A, Martin-Ferrero M, Del Canto F, Alberca M, Garcia V, Munar A . Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A Randomized Controlled Trial. Transplantation. 2015; 99(8):1681-90. DOI: 10.1097/TP.0000000000000678. View

Lamo-Espinosa J, Mora G, Blanco J, Granero-Molto F, Nunez-Cordoba J, Sanchez-Echenique C . Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: multicenter randomized controlled clinical trial (phase I/II). J Transl Med. 2016; 14(1):246. PMC: 5002157. DOI: 10.1186/s12967-016-0998-2. View

10.

Xia P, Wang X, Lin Q, Li X . Efficacy of mesenchymal stem cells injection for the management of knee osteoarthritis: a systematic review and meta-analysis. Int Orthop. 2015; 39(12):2363-72. DOI: 10.1007/s00264-015-2785-8. View

11.

Centeno C, Busse D, Kisiday J, Keohan C, Freeman M, Karli D . Increased knee cartilage volume in degenerative joint disease using percutaneously implanted, autologous mesenchymal stem cells. Pain Physician. 2008; 11(3):343-53. View

12.

Yubo M, Yanyan L, Li L, Tao S, Bo L, Lin C . Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis. PLoS One. 2017; 12(4):e0175449. PMC: 5407776. DOI: 10.1371/journal.pone.0175449. View

13.

Abramson S, Attur M . Developments in the scientific understanding of osteoarthritis. Arthritis Res Ther. 2009; 11(3):227. PMC: 2714096. DOI: 10.1186/ar2655. View

14.

Wang P, Li Y, Huang L, Yang J, Yang R, Deng W . Effects and safety of allogenic mesenchymal stem cell intravenous infusion in active ankylosing spondylitis patients who failed NSAIDs: a 20-week clinical trial. Cell Transplant. 2013; 23(10):1293-303. DOI: 10.3727/096368913X667727. View

15.

Shapiro S, Kazmerchak S, Heckman M, Zubair A, OConnor M . A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Am J Sports Med. 2016; 45(1):82-90. DOI: 10.1177/0363546516662455. View

16.

Grassel S, Lorenz J . Tissue-engineering strategies to repair chondral and osteochondral tissue in osteoarthritis: use of mesenchymal stem cells. Curr Rheumatol Rep. 2014; 16(10):452. PMC: 4182613. DOI: 10.1007/s11926-014-0452-5. View

17.

Wakitani S, Imoto K, Yamamoto T, Saito M, Murata N, Yoneda M . Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage. 2002; 10(3):199-206. DOI: 10.1053/joca.2001.0504. View

18.

Saw K, Anz A, Jee C, Merican S, Ng R, Roohi S . Articular cartilage regeneration with autologous peripheral blood stem cells versus hyaluronic acid: a randomized controlled trial. Arthroscopy. 2013; 29(4):684-94. DOI: 10.1016/j.arthro.2012.12.008. View

19.

Moher D, Jadad A, Nichol G, Penman M, Tugwell P, Walsh S . Assessing the quality of randomized controlled trials: an annotated bibliography of scales and checklists. Control Clin Trials. 1995; 16(1):62-73. DOI: 10.1016/0197-2456(94)00031-w. View

20.

Banfi A, Bianchi G, Notaro R, Luzzatto L, Cancedda R, Quarto R . Replicative aging and gene expression in long-term cultures of human bone marrow stromal cells. Tissue Eng. 2003; 8(6):901-10. DOI: 10.1089/107632702320934001. View