Mesenchymal stem cell implantation provides short‐term clinical improvement and satisfactory cartilage restoration in patients with knee osteoarthritis but the evidence is limited: a systematic review performed by the early‐osteoarthritis group of ESSKA‐European knee associates section

Abstract

Purpose Implantation of mesenchymal stem cells (MSCs) is a potential cell-based modality for cartilage repair. Currently, its clinical use largely surrounds focal cartilage defect repair and intra-articular injections in knee osteoarthritis. The MSCs’ implantation efficacy as a treatment option for osteoarthritis remains contentious. This systematic review aims to evaluate studies that focused on MSCs implantation in patients with knee OA to provide a summary of this treatment option outcomes. Methods A systematic search was performed in PubMed (Medline), Scopus, Cinahl, and the Cochrane Library. Original studies investigating outcomes of MSCs implantations in patients with knee OA were included. Data on clinical outcomes using subjective scores, radiological outcomes, and second-look arthroscopy gradings were extracted. Results Nine studies were included in this review. In all included studies, clinical outcome scores revealed significantly improved functionality and better postoperative pain scores at 2–3 years follow-up. Improved cartilage volume and quality at the lesion site was observed in five studies that included a postoperative magnetic resonance imaging assessment and studies that performed second-look arthroscopy. No major complications or tumorigenesis occurred. Outcomes were consistent in both single MSCs implantation and concurrent HTO with MSCs implantation in cases with excessive varus deformity. Conclusion According to the available literature, MSCs implantation in patients with mild to moderate knee osteoarthritis is safe and provides short-term clinical improvement and satisfactory cartilage restoration, either as a standalone procedure or combined with HTO in cases with axial deformity. However, the evidence is limited due to the high heterogeneity among studies and the insufficient number of studies including a control group and mid-term outcomes. Level of evidence IV.

Regulation of Oxygen Tension as a Strategy to Control Chondrocytic Phenotype for Cartilage Tissue Engineering and Regeneration

“…However, the clinical trials related to cartilage repair suffer, for instance, from the inclusion of a relatively low number of patients, non-standardized treatments regarding the source of MSCs, their cell isolation methods and cellular dosage [ 30 ]. Still, at least short-term clinical improvements were observed in a recent systematic review of MSC implantation outcomes in patients with knee OA [ 31 ].…”

Glycosphingolipids in Osteoarthritis and Cartilage Regeneration Therapy: Mechanisms and Therapeutic Prospects

“…Sialic acids are negatively charged sugars expressed at the terminal positions of N-and O-linked oligosaccharides, which are attached to cell surfaces or secreted glycoproteins. As a result of their non-reducing terminal position, sialic acids are involved in highly specific recognition phenomena [133,134] [ [116][117][118][119][120][121][122] predominantly express α-2-6-specific sialyltransferases and α-2-6-linked sialic acid residues in glycoprotein N-glycans [135]. Interestingly, inflammation stimuli induced a shift from α-2-6-linked towards α-2-3-linked sialic acid, suggesting that α-2-6-linked sialic acid can be used as a biomarker for quality control in amplified human cartilage.…”

Evaluating the efficacy of mesenchymal stem cells for diabetic neuropathy: A systematic review and meta-analysis of preclinical studies

“…Furthermore, MSCs are readily available, as they can be isolated from various tissues, including but not limited to bone marrow, adipose tissue, and teeth; they are able to multiply rapidly in vitro , undergoing several to a dozen passages ( Li and Wang, 2022 ). Importantly, clinical trials from different countries have demonstrated the safety of MSCs, as evidenced by the fact that no allergic or severe adverse reactions were observed up to years after years of transplantation ( Arango-Rodríguez et al, 2023 ; Razak et al, 2023 ; Xie et al, 2023 ). Therefore, treatment of MSCs could offer significant potential in treating tissue damage and functional disorders.…”