Efficacy and safety of mesenchymal stem cell injections for patients with osteoarthritis: a meta-analysis and review of RCTs

Abstract

Introduction

Osteoarthritis (OA), which has a high incidence in the elderly, brings a huge economic burden to society. MSCs (Mesenchymal Stem Cells) have shown great multidirectional differentiation potential which are expected to treat OA, and numerous clinical trials have been conducted. However, the efficacy and safety of the MSCs still need to be further integrated and analyzed.

Materials and methods

We searched several databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, Ovid, and ScienceDirect) for assessing eligible trials that randomized controlled trials, hyaluronic acid as control, and MSCs injection to treat OA. Vitro studies and animal studies were excluded. Search terms were: “cartilage,” “clinical trial,” “mesenchymal,” “stromal” and “stem cell”, “osteoarthritis”. The preliminary guidelines and study protocol were published online at PROSPERO.

Results

Many assessment scales could not be improved significantly after 6 months. However, most of the scales were significantly improved after 12 months, indicating that compared with hyaluronic acid, stem cells could relieve OA symptoms significantly. No serious adverse effect was found.

Conclusion

There are significant therapeutic effects on joint function, symptoms, and no permanent adverse effect has been found after stem cell treatment. It is promising to apply intro-articular injection of stem cells for OA to clinical application. More researches are needed to supplement present deficiencies.

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Funding

This study was funded by Youth Medical Key Talent Project of Jiangsu (QNRC2016844) and the eighteenth batch of scientific research projects of Jiangsu University (18A509).

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Conceptualization: PJ. Data collection: PJ and LM. Project administration: DL. Methodology: QZ and LQ. Formal analysis: QZ and LM. Funding acquisition: DL and PJ. Investigation: XL. Software: PJ and XL. Resources: PJ and LM. Supervision: DL. Validation: QZ. Visualization: PJ. Writing ± original draft: PJ. Writing ± review and editing: DL and QZ.

Corresponding author

Correspondence to Dapeng Li.

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All the authors declare that they have no conflict of interest. The authors thank MD Chao Shen for his contributions to this scientific work and Dr. Abdulraheem Gul for his contributions to language improvement.

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Jiang, P., Mao, L., Qiao, L. et al. Efficacy and safety of mesenchymal stem cell injections for patients with osteoarthritis: a meta-analysis and review of RCTs. Arch Orthop Trauma Surg (2021). https://doi.org/10.1007/s00402-020-03703-0

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Keywords

  • Mesenchymal stem cells
  • Osteoarthritis
  • Therapy
  • Adverse effects