Stem Cells in Articular Cartilage Regeneration 

A SYSTEMATIC REVIEW

Published: 16th April 2016 in the Journal of Orthopaedic Surgery and Research

Abstract

Mesenchymal stem cells (MSCs) have emerged as a promising option to treat articular defects and early osteoarthritis (OA) stages. However, both their potential and limitations for a clinical use remain controversial. Thus, the aim of this systematic review was to examine MSCs treatment strategies in clinical settings, in order to summarize the current evidence of their efficacy for the treatment of cartilage lesions and OA.Among the 60 selected studies, 7 were randomized, 13 comparative, 31 case series, and 9 case reports; 26 studies reported the results after injective administration, whereas 33 used surgical implantation.  We examined the cell source studies as listed below;

  • 20 Bone Marrow Stem cells (BMSC)
  • 17 Adipose Derived Stem Cells (ADSC)
  • 16 Bone Marrow Concentrate (BMC)
  • 5 Peripheral Blood Stem Cells (PBSC)
  • 1 Synovium Derived Stem Cells and (SDSC)
  • 1 compared BMC versus PBSCs.

Overall, despite the increasing literature on this topic, the evidence is still limited, in particular for high-level studies. On the other hand, the available studies allow to draw some indications. First, no major adverse events related to the treatment or to the cell harvest have been reported. Second, a clinical benefit of using MSCs therapies has been reported in most of the studies, regardless of cell source, indication, or administration method. This effectiveness has been reflected by clinical improvements and also positive MRI and macroscopic findings, whereas histologic features gave more controversial results among different studies. Third, young age, lower BMI, smaller lesion size for focal lesions, and earlier stages of OA joints have been shown to correlate with better outcomes, even though the available data strength does not allow to define clear cutoff values. Finally, definite trends can be observed with regard to the delivery method: currently cultured cells are mostly being administered by i.a. injection, while one-step surgical implantation is preferred for cell concentrates. In conclusion, while promising results have been shown, the potential of these treatments should be confirmed by reliable clinical data through double-blind, controlled, prospective and multicenter studies with longer follow-up, and specific studies should be designed to identify the best cell sources, manipulation, and delivery techniques, as well as pathology and disease phase indications.

REF: Filardo, G., Perdisa, F., Roffi, A., Marcacci, M., & Kon, E. (2016). Stem cells in articular cartilage regeneration. Journal Of Orthopaedic Surgery And Research, 11(1). http://dx.doi.org/10.1186/s13018-016-0378-x

 

If you would like to read more recent literature reviews. The 2017 systematic review for the use of stem cells in treating orthopaedic disorders can be found here.

 

Tags: Macquarie Stem Cells, Dr. Bright, Osteoarthritis Treatment, Dr. Ralph Bright, Stem Cell Therapy, Stem Cell Treatment, Stem Cells for Arthritis, Systematic Review, Literature Review