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Cited by 32Periodontal Regeneration and TreatmentsOsteoarthritis Treatment and MechanismsMesenchymal stem cell research

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 access
Zhao, Jinlong, Liang, Guihong, Han, Yanhong, Yang, Weiyi, Xu, Nanjun, Luo, Minghui, Pan, Jianke, Liu, Jun, Zeng, Ling-Feng·2022·BMJ Open
DOI 10.1136/bmjopen-2022-061008PMC PMC9670925
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Abstract

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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Crossref · 10.1136/bmjopen-2022-061008

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Figures

Figure 1 Flow chart of the included studies.
Figure 1 Flow chart of the included studies.CC BY-NC · PubMed Central
Figure 2 Risk of bias assessment.
Figure 2 Risk of bias assessment.CC BY-NC · PubMed Central
Figure 3 Forest plot of VAS score 12 months after treatment: MSCs+PRP versus control group (PRP and HA in control group). HA, hyaluronic acid; MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; VAS, Visual Analogue Scale.
Figure 3 Forest plot of VAS score 12 months after treatment: MSCs+PRP versus control group (PRP and HA in control group). HA, hyaluronic acid; MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; VAS, Visual Analogue Scale.CC BY-NC · PubMed Central
Figure 4 Forest plot of WOMAC score 12 months after treatment: MSCs+PRP versus control group (PRP and HA in control group). HA, hyaluronic acid; MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.
Figure 4 Forest plot of WOMAC score 12 months after treatment: MSCs+PRP versus control group (PRP and HA in control group). HA, hyaluronic acid; MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.CC BY-NC · PubMed Central

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Citations

Cites

Research works printed but not linked: 2

  1. Hou, 2016, Effect of intra-articular injection of bone marrow PrP on knee osteoarthritis, Med J of Communications, 30, 73
  2. 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

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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)
DOI
10.1136/bmjopen-2022-061008
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
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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