A Comprehensive Review of Stem Cells for Cartilage Regeneration in Osteoarthritis

  • Gauthaman Kalamegam
  • Adnan Memic
  • Emma Budd
  • Mohammed Abbas
  • Ali MobasheriEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1089)


Osteoarthritis (OA) is an age related joint disease associated with degeneration and loss of articular cartilage. Consequently, OA patients suffer from chronic joint pain and disability. Weight bearing joints and joints that undergo repetitive stress and excessive ‘wear and tear’ are particularly prone to developing OA. Cartilage has a poor regenerative capacity and current pharmacological agents only provide symptomatic pain relief. OA patients that respond poorly to conventional therapies are ultimately treated with surgical procedures to promote cartilage repair by implantation of artificial joint structures (arthroplasty) or total joint replacement (TJR). In the last two decades, stem cells derived from various tissues with varying differentiation and tissue regeneration potential have been used for the treatment of OA either alone or in combination with natural or synthetic scaffolds to aid cartilage repair. Although stem cells can be differentiated into chondrocytes in vitro or aid cartilage regeneration in vivo, their potential for OA management remains limited as cartilage regenerated by stem cells fails to fully recapitulate the structural and biomechanical properties of the native tissue. Efficient tissue regeneration remains elusive despite the simple design of cartilage, which unlike most other tissues is avascular and aneural, consisting of a single cell type. In this article, we have comprehensively reviewed the types of stem cells that have been proposed or tested for the management of OA, their potential efficacy as well as their limitations. We also touch on the role of biomaterials in cartilage tissue engineering and examine the prospects for their use in cell-based therapies.


Chondrocytes In vitro In vivo Osteoarthritis Regenerative medicine Stem cells 



Two dimensional


Three dimensional


Autologous chondrocyte implantation


Autologous chondrocyte transplantation


Bone marrow


Bone marrow aspirate concentrate


Bone morphogenetic protein


Cluster of Differentiation




Cartilage pellet


Embryoid bodies


Embryonic stem cells


Food and drug administration


Hyaluronic acid


Haematopoietic stem cells


Induced pluripotent stem cells


International Society for Cellular Therapy


Matrix metallo-proteinase-13


Mesenchymal stem cells


Nonsteroidal anti-inflammatory drug




Platelet rich plasma


Synovial Fluid


Serotonin-norepinephrine reuptake inhibitors


Transforming growth factor beta


Total knee arthroplasty



The authors acknowledge the financial support provided by the “Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells” and the stem cell laboratory facility at CEGMR and King Abdulaziz University Hospital.

Conflicts of Interest

The authors declare no conflict of interests.

Competing Interests and Disclosures

The authors declare no competing interests.

Author’s Contributions

G. Kalamegam and A. Memic were involved in intellectual contribution and manuscript writing. MA and EB were involved in intellectual contribution and editing of the manuscript. A. Mobasheri contributed to the synthesis and editing of the manuscript.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gauthaman Kalamegam
    • 1
    • 2
  • Adnan Memic
    • 3
  • Emma Budd
    • 4
  • Mohammed Abbas
    • 2
    • 5
  • Ali Mobasheri
    • 2
    • 4
    • 6
    • 7
    Email author
  1. 1.Center of Excellence in Genomic Medicine ResearchKing Abdulaziz UniversityJeddahSaudi Arabia
  2. 2.Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis with Stem CellsKing Abdulaziz UniversityJeddahSaudi Arabia
  3. 3.Center of NanotechnologyKing AbdulAziz UniversityJeddahSaudi Arabia
  4. 4.Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
  5. 5.Department of Orthopaedic Surgery, Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
  6. 6.Arthritis Research UK Centre for Sport, Exercise and OsteoarthritisQueen’s Medical CentreNottinghamUK
  7. 7.Department of Regenerative MedicineState Research Institute Centre for Innovative MedicineVilniusLithuania

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