Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials

Objective: To systematically review randomized controlled trials (RCTs) to compare clinical outcomes of stromal cell-based injection therapies versus other non-operative treatment modalities for the treatment of knee osteoarthritis (OA). Method: A systematic review was performed by searching PubMed,...

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Main Authors: Jaydeep Dhillon, James A. Maguire, Matthew J. Kraeutler
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Osteoarthritis and Cartilage Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2665913125000445
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author Jaydeep Dhillon
James A. Maguire
Matthew J. Kraeutler
author_facet Jaydeep Dhillon
James A. Maguire
Matthew J. Kraeutler
author_sort Jaydeep Dhillon
collection DOAJ
description Objective: To systematically review randomized controlled trials (RCTs) to compare clinical outcomes of stromal cell-based injection therapies versus other non-operative treatment modalities for the treatment of knee osteoarthritis (OA). Method: A systematic review was performed by searching PubMed, Cochrane Library, and EMBASE to locate RCTs, published since 2019, comparing stromal cell-based injection therapies versus other non-operative modalities for the treatment of knee OA. The search terms used were: knee AND osteoarthritis AND injection AND randomized. Results: Seventeen studies (all Level I evidence) were included in this review with 972 patients undergoing treatment with stromal cell-based therapy (Intervention Group) and 651 patients in the control group (Control Group). Among the 17 studies, 7 used autologous adipose-derived mesenchymal stromal cells (MSCs) (ADMSCs), 2 studies used allogeneic ADMSCs, 4 used autologous bone marrow-derived MSCs (BMMSCs), 1 used allogeneic BMMSCs, 1 used allogeneic placental MSCs, 1 used umbilical cord-derived MSCs (UCMSCs), and 1 study used autologous ADMSCs, BMMSCs, or allogeneic UCMSCs. All but 3 studies reported significantly better clinical or radiological outcomes in the Intervention Group at final follow-up. A total of 5 and 3 studies reported adverse events occurring in the Intervention and the Control groups, respectively, but they were all self-limiting. Conclusions: Patients undergoing treatment of knee OA with MSCs might be expected to experience improvements in clinical and radiological outcomes in comparison to other non-operative modalities. Additional studies with mid-to long-term outcomes are needed to better determine the efficacy and safety of MSCs for the treatment of knee OA.
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spelling doaj-art-a777866e99e04388a2c8cc9d0d098a0c2025-08-20T02:32:54ZengElsevierOsteoarthritis and Cartilage Open2665-91312025-06-017210060810.1016/j.ocarto.2025.100608Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trialsJaydeep Dhillon0James A. Maguire1Matthew J. Kraeutler2Samaritan Health Services, Department of Orthopedics, Corvallis, OR 97330, USASt. Joseph's University Medical Center, Department of Orthopaedic Surgery, Paterson, NJ 07503, USATexas Tech University Health Sciences Center, Department of Orthopaedic Surgery & Rehabilitation, Lubbock, TX 79430, USA; Corresponding author. Texas Tech University Health Sciences Center, Department of Orthopaedic Surgery & Rehabilitation, 3601 4th St, Lubbock, TX 79430, USA.Objective: To systematically review randomized controlled trials (RCTs) to compare clinical outcomes of stromal cell-based injection therapies versus other non-operative treatment modalities for the treatment of knee osteoarthritis (OA). Method: A systematic review was performed by searching PubMed, Cochrane Library, and EMBASE to locate RCTs, published since 2019, comparing stromal cell-based injection therapies versus other non-operative modalities for the treatment of knee OA. The search terms used were: knee AND osteoarthritis AND injection AND randomized. Results: Seventeen studies (all Level I evidence) were included in this review with 972 patients undergoing treatment with stromal cell-based therapy (Intervention Group) and 651 patients in the control group (Control Group). Among the 17 studies, 7 used autologous adipose-derived mesenchymal stromal cells (MSCs) (ADMSCs), 2 studies used allogeneic ADMSCs, 4 used autologous bone marrow-derived MSCs (BMMSCs), 1 used allogeneic BMMSCs, 1 used allogeneic placental MSCs, 1 used umbilical cord-derived MSCs (UCMSCs), and 1 study used autologous ADMSCs, BMMSCs, or allogeneic UCMSCs. All but 3 studies reported significantly better clinical or radiological outcomes in the Intervention Group at final follow-up. A total of 5 and 3 studies reported adverse events occurring in the Intervention and the Control groups, respectively, but they were all self-limiting. Conclusions: Patients undergoing treatment of knee OA with MSCs might be expected to experience improvements in clinical and radiological outcomes in comparison to other non-operative modalities. Additional studies with mid-to long-term outcomes are needed to better determine the efficacy and safety of MSCs for the treatment of knee OA.http://www.sciencedirect.com/science/article/pii/S2665913125000445Injection therapyKnee osteoarthritisStromal stem cells
spellingShingle Jaydeep Dhillon
James A. Maguire
Matthew J. Kraeutler
Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
Osteoarthritis and Cartilage Open
Injection therapy
Knee osteoarthritis
Stromal stem cells
title Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
title_full Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
title_fullStr Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
title_full_unstemmed Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
title_short Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials
title_sort stromal cell based injection therapies for the treatment of knee osteoarthritis a systematic review of level i randomized controlled trials
topic Injection therapy
Knee osteoarthritis
Stromal stem cells
url http://www.sciencedirect.com/science/article/pii/S2665913125000445
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