Safety and Efficacy of Injecting Mesenchymal Stem Cells Into a Human Knee Joint To Treat Osteoarthritis: A Systematic Review

Shoukrie, Shoukrie I; Venugopal, Sathish; Dhanoa, Ravneet K; Selvaraj, Ramaneshwar; Selvamani, Tharun Yadhav; Zahra, Anam; Malla, Jyothirmai; Hamouda, Ranim K; Hamid, Pousette

doi:10.7759/cureus.24823

Cited by 15 publications

(13 citation statements)

References 71 publications

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“…e gradual change of tendon composition will inevitably lead to the change of its function, resulting in the abnormal mechanical function of quadriceps femoris, the change of motion support effect of quadriceps femoris on the knee joint, and the change of mechanical trajectory of the knee joint, which all occurred before the obvious lesion of the knee joint structure. Pain is the earliest signal released by KOA [18][19][20]. Some scholars believe that the change in internal stress on the knee joint leads to synovitis, and the injured synovial cells release inflammatory mediators and matrix-degrading enzymes into the joint cavity, causing the joint to experience feedback and progressive joint degeneration.…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Preliminary Study on Grading Diagnosis of Early Knee Osteoarthritis by Shear Wave Elastography

Zhang

Lin

Jiang

et al. 2022

Contrast Media & Molecular Imaging

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Knee osteoarthritis (KOA) is the most common chronic bone joint disease. The WHO points out that KOA has become the fourth most disabling disease in the world, and the main clinical treatment is prevention. At present, the clinical diagnosis of knee osteoarthritis with deformation is mainly made by X-ray and two-dimensional ultrasound, and the preventive treatment effect is not good. Shear wave elastography (SWE) has been widely used in clinical practice for its advantages of noninvasive, simple, rapid, and high accuracy in soft tissue hardness. This study investigates the feasibility of using SWE in the grading diagnosis of KOA and the detection of early skeletal muscle injury. 60 patients were enrolled with unilateral KOA who met the inclusion criteria. Routine scanning and SWE exploration were carried out and compared between the affected and healthy knee joints. The measurements included morphology, damage degree of cartilage, joint effusion, joint synovial thickness, the degree of meniscus convexity, and shear wave speed (SWS) in the tendon attachment area of the quadriceps femoris superior patella, and tendon thickness and SWS between and within groups. The affected was scored according to the ultrasonic characteristics. The correlation between them was analyzed to evaluate the feasibility of SWE in grading the diagnosis of KOA. 57 cases had knee cavity effusion (57/60, 95.0%), 58 cases had knee cartilage injury (58/60, 96.6%), and 35 cases had a lateral process of the medial meniscus (35/60, 53.3%); 30 cases had synovial hyperplasia (30/60, 50%), 21 cases had osteophyte formation (21/60, 35%), and no one had a popliteal cyst. There was no significant difference in tendon thickness between and within groups ( p > 0.05 ), but a significant difference in SWS ( p < 0.01 ); the SWS of the quadriceps femoris tendon is negatively correlated with ultrasound score (r = 0.955, p < 0.01 ). There is a strong negative correlation between SWS and the degree of KOA. It can be used in the grading diagnosis of KOA to help find more early strain points.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Preliminary Study on Grading Diagnosis of Early Knee Osteoarthritis by Shear Wave Elastography

Zhang

Lin

Jiang

et al. 2022

Contrast Media & Molecular Imaging

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“…Table 1 summarizes systematic reviews and meta-analyses on the clinical efficacy of intraarticular injections of MSCs in knee OA [ 19 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ].…”

Section: Efficacy Of Intraarticular Mscs Injections In Knee Osteoarth...mentioning

confidence: 99%

Intraarticular Injections of Mesenchymal Stem Cells in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy

Rodríguez-Merchán

2022

IJMS

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More than 10% of the world’s population suffers from osteoarthritis (OA) of the knee, with a lifetime risk of 45%. Current treatments for knee OA pain are as follows: weight control; oral pharmacological treatment (non-steroidal anti-inflammatory drugs, paracetamol, opioids); mechanical aids (crutches, walkers, braces, orthotics); therapeutic physical exercise; and intraarticular injections of corticosteroids, hyaluronic acid, and platelet-rich plasma (PRP). The problem is that such treatments usually relieve joint pain for only a short period of time. With respect to intraarticular injections, corticosteroids relieve pain for several weeks, while hyaluronic acid and PRP relieve pain for several months. When the above treatments fail to control knee pain, total knee arthroplasty (TKA) is usually indicated; however, although a very effective surgical technique, it can be associated with medical and postoperative (surgery-related) complications. Therefore, it seems essential to look for safe and effective alternative treatments to TKA. Recently, there has been much research on intraarticular injections of mesenchymal stem cells (MSCs) for the management of OA of the knee joint. This article reviews the latest information on the molecular mechanisms of action of MSCs and their potential therapeutic benefit in clinical practice in patients with painful knee OA. Although most recent publications claim that intraarticular injections of MSCs relieve joint pain in the short term, their efficacy remains controversial given that the existing scientific information on MSCs is indecisive. Before recommending intraarticular MSCs injections routinely in patients with painful knee OA, more studies comparing MSCs with placebo are needed. Furthermore, a standard protocol for intraarticular injections of MSCs in knee OA is needed.

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“…Over the past decades, intra-articular injection of various stem cells has emerged as an advanced therapy to delay the pathological progress of OA. Among them, some mesenchymal stem cells (MSCs), including adipose mesenchymal stem cells (ADSCs) and bone marrow mesenchymal stem cells (BMSCs), have become the most preferred therapeutic cells for treating OA owing to their extensive sources, accessibility, multi-directional differentiation, and the enviable paracrine effects ( Molnar et al, 2022 ; Shoukrie et al, 2022 ; Zeng et al, 2022 ). Intra-articular injection of MSCs is well-proven as an alternative treatment to repair damaged cartilage, delay the pathological progress of OA, as well as relieve pain ( Csaki et al, 2008 ; Maumus et al, 2011 ; Yin B. et al, 2022 ; Lin et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Naturally derived injectable hydrogels with ROS-scavenging property to protect transplanted stem cell bioactivity for osteoarthritic cartilage repair

Xiang

Gong

et al. 2023

Front. Bioeng. Biotechnol.

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Intra-articular injection of adipose mesenchymal stem cells (ADSCs) is a potential alternative to the treatment of osteoarthritis (OA) and has aroused great interest of clinical researchers. However, the hostile microenvironment in the joint cavity, characterized by reactive oxygen species (ROS) accumulation and excessive inflammation, disturbs the bioactivity of the transplanted stem cells. The (-)-epigallocatechin-3-O-gallate (EGCG), a green tea catechin, has attracted the researchers’ attention owing to its powerful ROS-scavenging and antioxidant properties. In this study, to avoid rapid degradation and/or depletion of EGCG, we prepare a long-lasting injectable hydrogel by EGCG and hyaluronic acid (HA). The naturally derived hydrogels with excellent biocompatibility and durable retention time can capture the redundant ROS continuously and efficiently, thus protecting ADSCs from ROS-mediated death and bioactivity inhibition, including cell survival, proliferation and chondrogenic differentiation. Intra-articular injection of this ADSCs loaded hydrogel significantly induced synovial macrophages polarization to M2 phenotype, decreased pro-inflammatory cytokines (e.g., IL-1β, MMP-13, and TNF-α) expression, promoted cartilage matrix formation, and repaired cartilage destruction in OA. This stem cell-protected hydrogel delivery strategy showed superior efficacy than ADSCs delivering or EGCG-HA injection singly, which providing a potential alternative strategy for OA management.

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Safety and Efficacy of Injecting Mesenchymal Stem Cells Into a Human Knee Joint To Treat Osteoarthritis: A Systematic Review

Cited by 15 publications

References 71 publications

[Retracted] Preliminary Study on Grading Diagnosis of Early Knee Osteoarthritis by Shear Wave Elastography

[Retracted] Preliminary Study on Grading Diagnosis of Early Knee Osteoarthritis by Shear Wave Elastography

Intraarticular Injections of Mesenchymal Stem Cells in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy

Naturally derived injectable hydrogels with ROS-scavenging property to protect transplanted stem cell bioactivity for osteoarthritic cartilage repair

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