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Cited by 34Mesenchymal stem cell researchOsteoarthritis Treatment and MechanismsPeriodontal Regeneration and Treatments

Transplantation of three mesenchymal stem cells for knee osteoarthritis, which cell and type are more beneficial? a systematic review and network meta-analysis

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Chen, Xiyang, Zheng, Jinglu, Yin, Li, Li, Yikai, Liu, Hongwen·2024·Journal of Orthopaedic Surgery and Research
DOI 10.1186/s13018-024-04846-1PMC PMC11188250
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Abstract

Background: In knee osteoarthritis (KOA), treatments involving knee injections of bone marrow-derived mesenchymal stem cells (BM-MSC), adipose tissue-derived mesenchymal stem cells (AD-MSC), or umbilical cord-derived mesenchymal stem cells (UC-MSC) have shown promise in alleviating symptoms. However, which types of mesenchymal stem cells (MSCs) have the best therapeutic outcomes remain uncertain. Method: We systematically searched PubMed, OVID, Web of Science, and the Cochrane Library until January 1, 2024. The study evaluated five endpoints: Visual Analog Score (VAS) for Pain, Range of Motion (ROM), Whole-Organ Magnetic Resonance Imaging Score (WORMS), Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and adverse events (ADs). Standard meta-analysis and network meta-analysis were performed using Stata 16.0. Results: Fifteen studies involving 585 patients were included in the meta-analysis. Standard meta-analysis revealed significant improvements with MSCs in VAS score ( P < 0.001), knee ROM ( P < 0.001), and WOMAC ( P < 0.016) compared to traditional therapy. In the network meta-analysis, autologous MSCs significantly improved VAS score [SMD = 2.94, 95% CI (1.90, 4.56)] and knee ROM [SMD = 0.26, 95% CI (0.08, 0.82)] compared to traditional therapy. Similarly, BM-MSC significantly improved VAS score [SMD = 0.31, 95% CI (0.11, 0.91)] and knee ROM [SMD = 0.26, 95% CI (0.08, 0.82)] compared to hyaluronic acid. However, compared with traditional therapy, autologous or allogeneic MSCs were associated with more adverse reactions [SMD = 0.11, 95% CI (0.02, 0.59)], [SMD = 0.13, 95% CI (0.002, 0.72)]. Based on the surface under the cumulative ranking results, autologous BM-MSC showed the most improvement in ROM and pain relief in KOA patients, UC-MSC (SUCRA 94.1%) were most effective for positive WORMS, and AD-MSC (SUCRA 70.6%) were most effective for WOMAC-positive patients. Conclusion: MSCs transplantation effectively treats KOA patients, with autologous BM-MSC potentially offering more excellent benefits.

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  • High treatment costs, ethical concerns, and regulatory barriers hinder clinical translation of MSC therapies.

    “However, their clinical translation remains hindered by high treatment costs, ethical concerns, and regulatory barriers [111].”

    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 [111]

    The Discussion (page not available) says ethical concerns about tissue and cellular product manipulation must be addressed to translate stem-cell research into clinical practice for knee osteoarthritis. It does not identify high MSC treatment costs or regulatory barriers as obstacles; its Introduction discusses the cost of osteoarthritis, not the cost of MSC therapy. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Chen, X., Zheng, J., Yin, L., Li, Y., & Liu, H.
Affiliations
  • Guangzhou University of Chinese Medicine (CN)
  • Panzhihua Central Hospital (CN)
  • Third Affiliated Hospital of Southern Medical University (CN)
Corresponding author
  • Li, Yikai
  • Liu, Hongwen
ORCID
Venue
Journal of Orthopaedic Surgery and Research
Publisher
Springer Science and Business Media LLC
Published
2024-06-20
Volume
19
Issue
1
Pages
366-366
ISSN
1749-799X (ISSN-L)
DOI
10.1186/s13018-024-04846-1
PMC
PMC11188250
OpenAlex
W4399868052
Cited by
34
References
6
Citations by year
2026: 11 · 2025: 21 · 2024: 2
FWCI
2.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Orthopaedic Surgery and Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Sanming Project of Medicine in Shenzhen (SZZYSM202108013)
  • President Foundation of The Third Affiliated Hospital of Southern Medical University (YP202210)
Topics
  • Health Sciences › Medicine › Genetics › Mesenchymal stem cell research
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
knee osteoarthritis, mesenchymal stem cells, bone marrow-derived mesenchymal stem cells, adipose-derived stem cells, human umbilical cord mesenchymal stem cells, autologous stem cell transplantation, allogeneic stem cell transplantation, knee injection, pain, range of motion, WOMAC, adverse events, hyaluronic acid
MeSH terms
Network Meta-Analysis, Adipose Tissue, Female, Humans, Male, Middle Aged, Pain Measurement, Transplantation, Autologous, Umbilical Cord, Range of Motion, Articular, Treatment Outcome, Osteoarthritis, Knee, Mesenchymal Stem Cell Transplantation, Mesenchymal Stem Cells

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