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Moreno Babilonia, C. A., Sánchez Palacio, N., & Cabarcas López, W. F. (2023). Efficacy of mesenchymal stem cells in the treatment of knee osteoarthritis: systematic review. Biosalud, 18(2), 61–80. https://doi.org/10.17151/biosa.2019.18.2.5
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Abstract
Introduction: Stem cells are considered to be one of the greatest potential treatments to degenerative diseases. Intraarticular stem cell therapy has become increasingly used to treat knee osteoarthritis with little highquality evidence to support its use. So, the effectiveness, safety and its potential are worthy to be explored. Objective: To evaluate the quality of the evidence on the clinical and radiological efficacy of the use of intraarticular mesenchymal cells in comparison with other intra-articular treatments against knee osteoarthritis of any etiology for adult patients, reported between 2016 and 2021. Materials and methods: A systematic review of the literature was carried out in different databases of articles published between January 1st, 2016 and August 22nd, 2021. Studies that can provide an answer following the guidelines of the PRISMA 2020 declaration. Results: Twenty-two clinical trials were compared, including 668 patients with knee osteoarthritis. All studies included patients with a body mass index below 35 kg/m2 and Kellgren-Lawrence osteoarthritis ranging from grades I to IV. Conclusions: In general, MSC treatment shows to be safe and has great potential as an effective clinical therapy for patients with knee osteoarthritis, although its efficacy and safety need to be evaluated more rigorously with trials with less risk of bias.
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References
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2. Harrison. Principios de medicina interna 20 ed. México, D.F: McGraw-Hill; 2018.
3. Viteri-Tapia FJ, Muñoz-Suárez DA, Rosales-Pérez GJ, Hernández-Izurieta JP, Jaramillo Villalobos JS, Cortés Naranjo CW. Osteoartrosis. Una revisión de literatura. Rev cubana de Reumatolo. 2019 [citado 31 May 2021]:, 21(2):[aprox. 0 p.]. Doi: http://www.revreumatologia.sld.cu/index.php/reumatologia/article/view/738
4. Zhao L, Kaye A, Abd-Elsayed A. Stem cells for the treatment of knee osteoarthritis: a comprehensive review. Pain Physician. 2018; 21(3):229-242. Available from: https://pubmed.ncbi.nlm.nih.gov/29871367/
5. Temple-Wong M, Ren S, Quach P, Hansen B, Chen A, Hasegawa A, y col. Hyaluronan concentration and size distribution in human knee synovial fluid: variations with age and cartilage degeneration. Arthritis Res Ther. 2016;18:18. doi: 10.1186/s13075-016-0922-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721052/
6. Hopman W, Harrison M, Coo H, Friedberg E, Buchanan M, VanDenKerkhof E. Associations between chronic disease, age and physical and mental health status. Chronic Dis Can. 2009; 29(3):108–116. doi: 10.24095/hpcdp.29.3.03. Available from: https://pubmed.ncbi.nlm.nih.gov/19527569/
7. Harris H, Crawford A. Recognizing and managing osteoarthritis. Nursing. 2015; 45(1):36-42. doi: 10.1097/01.NURSE.0000458918.87973.15. Available from: https://pubmed.ncbi.nlm.nih.gov/25479404/
8. Barry F, Murphy M. Mesenchymal stem cells in joint disease and repair. Nat Rev Rheumatol 9:584-594. 2013. Available from: https://pubmed.ncbi.nlm.nih.gov/23881068/
9. Davatchi F, Sadeghi Abdollahi B, Mohyeddin M, Nikbin B. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. Int J Rheum Dis. 2016; 19:219-225. Available from: https://pubmed.ncbi.nlm.nih.gov/25990685/
10. Kurtz S, Ong K, Lau E, Mowat F, Halpern M.Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Jt Surg Ser A. 2007; 89:780-785. Available from: https://pubmed.ncbi.nlm.nih.gov/17403800/
11. Derar H, Shahinpoor M. Recent patents and designs on hip replacement prostheses. Open Biomed Eng J. 2015 Mar 31; 9:92-102. doi: 10.2174/1874120701509010092. PMID: 25893020; PMCID: PMC4397822. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397822/
12. Srimongkol S. A review of mathematical modeling in total hip replacement. Int Math Forum. 2012; 7:2561–2569. Available from: https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.461.7483&rep=rep1&type=pdf
13. Ding DC, Chang YH, Shyu WC, Lin SZ. Human umbilical cord mesenchymal stem cells: a new era for stem cell therapy. Cell Transplant. 2015; 24(3):339-47. doi: 10.3727/096368915X686841. Epub 2015 Jan 23. PMID: 25622293.
14. Andia I, Maffulli N. Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis. Ther Adv Musculoskelet Dis. 2021; 13:1759720X21996953. doi:10.1177/1759720X21996953. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897835/
15. Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C, Shamseer L, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29; 372:n71. doi: 10.1136/bmj.n71.
16. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996 Feb; 17(1):1-12. doi: 10.1016/0197-2456(95)00134-4.
17. Halpern SH, Douglas MJ. Appendix: Jadad Scale for Reporting Randomized Controlled Trials. In: Halpern SH, Douglas MJ, editors. Evidence-based Obstetric Anesthesia. Blackwell Publishing Ltd; 2005. p. 237-238. doi: 10.1002/9780470988343.app. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470988343.app.
18. RevMan 5. Cochrane.org. [citado el 17 de diciembre de 2021]. Doi: https://training.cochrane.org/online-learning/coresoftware-cochrane-reviews/revman/revman-5-download
19. Ding DC, Shyu WC, Lin SZ. Mesenchymal stem cells. Cell Transplant. 2011; 20(1):5-14. doi: 10.3727/096368910X. PMID: 21396235.
20. Lamo-Espinosa JM, Mora G, Blanco JF, Granero-Moltó F, Nuñez-Córdoba JM, Sánchez-Echenique C, et al. 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). doi:http://dx.doi.org/10.1186/s12967-016-0998-2.
21. Lee W-S, Kim HJ, Kim K-I, Kim GB, Jin W. Intra-articular injection of autologous adipose tissuederived mesenchymal stem cells for the treatment of knee osteoarthritis: A phase IIb, randomized, placebo-controlled clinical trial: Autologous MSCs for knee osteoarthritis. Stem Cells Transl Med. 2019; 8(6):504-11. doi: 10.1002/sctm.18-0122.
22. Lu L, Dai C, Zhang Z, Du H, Li S, Ye P, et al. Treatment of knee osteoarthritis with intra-articular injection of autologous adipose-derived mesenchymal progenitor cells: a prospective, randomized, double-blind, active-controlled, phase IIb clinical trial. Stem Cell Res Ther. 2019; 10(1):143. doi: 10.1186/s13287-019-1248-3.
23. Al-Najar M, Khalil H, Al-Ajlouni J, Al-Antary E, Hamdan M, Rahmeh R, et al. Intra-articular injection of expanded autologous bone marrow mesenchymal cells in moderate and severe knee osteoarthritis is safe: a phase I/II study. J Orthop Surg Res. 2017; 12(1). doi: http://dx.doi.org/10.1186/s13018-017-0689-6.
24. Matas J, Orrego M, Amenabar D, Infante C, Tapia-Limonchi R, Cadiz MI, et al. Umbilical cord-derived mesenchymal stromal cells (MSCs) for knee osteoarthritis: Repeated MSC dosing is superior to a single MSC dose and to hyaluronic acid in a controlled randomized phase I/II trial. Stem Cells Transl Med. 2019; 8(3):215-24. doi: http://dx.doi.org/10.1002/sctm.18-0053.
25. Shapiro SA, Kazmerchak SE, Heckman MG, Zubair AC, O’Connor MI. A prospective, single-blind, placebo-controlled trial of bone marrow aspirate concentrate for knee osteoarthritis. Am J Sports Med. 2017; 45(1):82-90. doi: http://dx.doi.org/10.1177/0363546516662455
26. Khalifeh-Soltani S, Forogh B, Ahmadbeigi N, Hadizadeh Kharazi H, Fallahzadeh K, Kashani L, et al. Safety and efficacy of allogenic placental mesenchymal stem cells for treating knee osteoarthritis: a pilot study. Cytotherapy. 2019; 21(1):54-63. doi: 10.1016/j.jcyt.2018.11.003.
27. Tsubosaka M, Matsumoto T, Sobajima S, Matsushita T, Iwaguro H, Kuroda R. The influence of adiposederived stromal vascular fraction cells on the treatment of knee osteoarthritis. BMC Musculoskelet Disord. 2020; 21(1):207. doi: http://dx.doi.org/10.1186/s12891-020-03231-3.
28. Vega A, Martin-Ferrero MA, Del Canto F, Alberca M, Garcia V, Munar A, et al. Treatment of knee osteoarthritis with allogeneic bone marrow mesenchymal stem cells: a randomized controlled trial. Transplantation. 2015; 99(8):1681-90. doi: http://dx.doi.org/10.1097/TP.0000000000000678
29. Wang Y, Jin W, Liu H, Cui Y, Mao Q, Fei Z, et al. Curative effect of human umbilical cord mesenchymal stem cells by intra articular injection for degenerative knee osteoarthritis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016; 30(12):1472-7. doi: http://dx.doi.org/10.7507/1002-1892.20160305
30. Bastos R, Mathias M, Andrade R, Amaral RJFC, Schott V, Balduino A, et al. Intra-articular injection of culture-expanded mesenchymal stem cells with or without addition of platelet-rich plasma is effective in decreasing pain and symptoms in knee osteoarthritis: a controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 2020; 28(6):1989-99. doi: http://dx.doi.org/10.1007/s00167-019-05732-8
31. Chahal J, Gómez-Aristizábal A, Shestopaloff K, Bhatt S, Chaboureau A, Fazio A, et al. Bone marrow mesenchymal stromal cell treatment in patients with osteoarthritis results in overall improvement in pain and symptoms and reduces synovial inflammation. Stem Cells Transl Med. 2019; 8(8):746-57. doi: http://dx.doi.org/10.1002/sctm.18-0183
32. Emadedin M, Labibzadeh N, Liastani MG, Karimi A, Jaroughi N, Bolurieh T, et al. Intra-articular implantation of autologous bone marrow-derived mesenchymal stromal cells to treat knee osteoarthritis: a randomized, triple-blind, placebo-controlled phase 1/2 clinical trial. Cytotherapy. 2018; 20(10):1238-46. doi: http://dx.doi.org/10.1016/j.jcyt.2018.08.005
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