Autologous Mesenchymal Stem Cell Treatment is Consistently Effective for the Treatment of Knee Osteoarthritis: The Results of a Systematic Review of Treatment and Comparison to a Placebo Group

Abstract

Background: Numerous studies have used autologous mesenchymal stem cell injections (AMSCI) to treat osteoarthritis. We hypothesized that AMSCI is an effective osteoarthritis treatment with increasing efficacy at higher doses. Methods: We conducted a PubMed search for human clinical studies using AMSCI for the treatment of osteoarthritis (OA) and a second search for placebo arms of injectate OA treatment. Inclusion criteria included treatment outcomes ratings both pre-treatment and at least 6 months post-treatment. Results: 45 AMSCI cohorts from 34 studies met criteria. All AMSCI cohorts showed improvement at mean 15.3 months post-treatment. Mean WOMAC and VAS scores improved at 6-months and at final follow-up (p < 0.0001 for all). Scores > 2 years were also significant (WOMAC p = 0.001/VAS p = 0.004). Results greatly exceeded the minimal clinically important difference (MCID) at each time point. AMSCI improvement also substantially exceeded previously published 6-month placebo-treatment improvement. No dose–response relationship was seen. AMSCI cohorts showed continuing improvement ≥ 6 months, and continued upward at one year. Placebo scores were already trending downward by 6 months. Conclusions: AMSCI is a consistently significantly effective treatment for osteoarthritis. It should no longer be stated that data is insufficient to establish AMSCI efficacy for OA. Given its excellent safety profile, AMSCI should be widely used for the treatment of osteoarthritis.

Short Term Clinical Results of Single Injection Autologous BMAC (Bone Marrow Aspirate Concentrate) As A Therapeutic Option/Tool in Knee Osteoarthritis

“…The latest studies on usage of Autologous BMAC injection in KOA showed promising and encouraging results in terms of decrease in the pain, improved knee range of movement, daily activities of living and thus improved expectations for good quality lives. These results with autologous BMAC are long lasting than other non surgical treatments and also showed better safety pro les [Prodromos C et al, 2020 Stem cells are the basic human cells that have potential to give rise to many different cell types, they are simple and differentiated. These will help to create new cells in existing healthy tissue and may help to repair in those structures that are injured or damaged.…”

Osteoartrite de joelho e o aspirado de medula óssea como escolha de tratamento - Uma revisão narrativa

“…Existem diferentes fontes para se coletar MSC. As duas autólogas utilizadas são da medula óssea e do tecido adiposo (Prodromos et al, 2020). Seus mecanismos fisiológicos ainda estão em estudo, mas as MSC possuem 3 meios já conhecidos que agem no tratamento da AO, são eles: a expressão de MicroRNA (MiRNA), conseguindo regular a tradução de mRNA de células vizinhas, que podem estimular o ambiente ao seu favor; a estimulação do reparo natural dos condrócitos pela secreção de fatores angiogênicos (VEGF e TGFB1), inibidores de apoptose (STC-1, SFRP2, TGFB1 e HGF), mitóticos (TGF-a, TGF-B, HGF, IGF-1, FGF-2, EGF) e anti-fibrose (KGF, SDF1, MIP1a, MIP1b); a imunomodulação, suprimindo as células Th1 e estimulando as Th2, trocando ainda os tipos de macrófagos e inibindo os linfócitos B (Mancuso et al, 2019) (Pittenger et al, 2019) (Ren et al, 2008).…”

Dietary Interventions with Polyphenols in Osteoarthritis: A Systematic Review Directed from the Preclinical Data to Randomized Clinical Studies

“…Revised recommendations by the American College of Rheumatology (ACR) for the current treatment approach in knee OA comprise of exercise, weight loss, topical and oral nonsteroidal anti-inflammatory drugs (NSAIDs), and intraarticular glucocorticoid injections [ 5 ]. Hyaluronic acid injections are also applied as lubricating agents, while autologous mesenchymal stem cell (MSC) treatment constitutes a rather recent and effective alternative for the treatment of knee OA [ 6 ].…”