The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials
Open accessAbstract
Objectives: The purpose of this meta-analysis was to investigate the efficacy and safety of mesenchymal stem cells (MSCs) combined with platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA). Design: Systematic review and meta-analysis. Participants: Patients with KOA. Interventions: Use of MSCs+PRP. Primary and secondary outcomes: Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and adverse reactions. Data sources: PubMed, Cochrane Library, Embase and China National Knowledge Infrastructure were searched from inception to 15 July 2021. Measures: The OR or weighted mean difference (WMD) of relevant outcome indicators was calculated. Study quality was evaluated using the risk-of-bias assessment tool version 2.0. Heterogeneity among studies was evaluated by calculating I 2 . If I 2 ＜50%, a fixed-effect model was applied; conversely, if I 2 ≥50%, a random-effect model was applied. Results: Six controlled clinical trials with 493 cases were included. The meta-analysis results showed that in terms of the VAS score 3 months after treatment, MSCs+PRP had no significant effect on the reduction of the VAS score in patients with KOA compared with the control (p=0.09), hyaluronic acid (HA) (p=0.15) or PRP alone (p=0.07). MSCs+PRP was more effective in reducing the VAS score at 6 and 12 months after treatment than the control (WMD=−0.55, 95% CI −0.87 to −0.22, p<0.001), HA (WMD=−1.20, 95% CI −2.28 to −0.13, p=0.03) or PRP alone (WMD=−0.54, 95% CI −0.89 to −0.18, p=0.003). Regarding the decrease in the total WOMAC score at 3 and 6 months after treatment, MSCs+PRP showed better clinical efficacy than the control or HA alone (p<0.01). Compared with the control, MSCs+PRP exhibited no significant difference in reducing the total WOMAC score 12 months after treatment (p=0.39). There was no significant difference between MSCs+PRP and the control in terms of improvement of the KOOS 12 months after treatment (p=0.16). Compared with MSCs alone, MSCs+PRP exhibited no significant difference in the incidence of adverse reactions (p=0.22) 12 months after treatment. Conclusions: Treatment with MSCs+PRP showed good clinical efficacy in improving pain and joint function in patients with KOA. Compared with MSCs alone, there was no significant difference in the incidence of adverse reactions with MSCs+PRP. PROSPERO registration number: CRD 42021275830.
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“Some trials have explored combination therapies such as MSC + PRP, which have shown enhanced cartilage regeneration and faster fracture healing compared to either intervention alone [98].”
From Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications (2025) · cites this paper as [98]
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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
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RoB 2: a revised tool for assessing risk of bias in randomised trials
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Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis
Bennell, K. L., Hunter, D. J., & Paterson, K. L. (2017) · Current Rheumatology Reports · doi:10.1007/s11926-017-0652-x · Cited by 279
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Self-citation
Research works printed but not linked: 2
- Hou, 2016, Effect of intra-articular injection of bone marrow PrP on knee osteoarthritis, Med J of Communications, 30, 73
- Cheng, 2019, Autologous bone marrow mesenchymal stem cells combined with platelet-rich plasma treats knee osteoarthritis, Chinese Journal of General Practice, 17, 1652
Cited by
Pintore, A., Notarfrancesco, D., Zara, A., Oliviero, A., Migliorini, F., Oliva, F., & Maffulli, N. (2023) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-023-03841-2 · Cited by 65
Mesenchymal Stromal Cells for Aging Cartilage Regeneration: A Review
Wu, K.-C., Chang, Y.-H., Ding, D.-C., & Lin, S.-Z. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252312911 · Cited by 33
Goulian, A. J., Goldstein, B., & Saad, M. A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14062061 · Cited by 25
“Some trials have explored combination therapies such as MSC + PRP, which have shown enhanced cartilage regeneration and faster fracture healing compared to either intervention alone [98].”
Metadata
- Authors
- Zhao, J., Liang, G., Han, Y., Yang, W., Xu, N., Luo, M., Pan, J., Liu, J., & Zeng, L.-F.
- Affiliations
- Guangzhou University of Chinese Medicine (CN)
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Corresponding author
- Liu, Jun
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2022-11
- Volume
- 12
- Issue
- 11
- Pages
- e061008
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC9670925
- OpenAlex
- W4309126464
- Cited by
- 32
- References
- 35
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 14 · 2023: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- the Project of Guangdong Provincial Department of Finance (No.[2018]8)
- the Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine (No.YN2019ML08, YN2015MS15)
- the Project of Administration of Traditional Chinese Medicine of Guangdong Province (No.20201129)
- the Key scientific research platforms and research projects of universities in Guangdong Province (No. 2018KQNCX041)
- the Medical Science Research Foundation of Guangdong Province (No. B2019091)
- National Natural Science Foundation of China (No.82004383, No. 82004386, No. 81873314, No. 81974)
- the Science and Technology Planning Project of Guangdong Province (No. 2020A1414050050)
- Topics
- Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Mesenchymal stem cell research
- Keywords
- knee osteoarthritis, mesenchymal stem cells, platelet-rich plasma, combination therapy, hyaluronic acid, analgesia, WOMAC score, KOOS, treatment safety, adverse effects, regenerative therapy, cartilage repair, knee function outcomes, treatment efficacy comparison, patient satisfaction, patient-reported outcomes, knee range of motion
- MeSH terms
- Humans, Hyaluronic Acid, Injections, Intra-Articular, Randomized Controlled Trials as Topic, Osteoarthritis, Knee, Platelet-Rich Plasma, Mesenchymal Stem Cells
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- Zhao, J., Liang, G., Han, Y., Yang, W., Xu, N., Luo, M., Pan, J., Liu, J., & Zeng, L.-F. (2022). Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials. BMJ Open. https://doi.org/10.1136/bmjopen-2022-061008
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