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- Title
Transplantation of three mesenchymal stem cells for knee osteoarthritis, which cell and type are more beneficial? a systematic review and network meta-analysis.
- Authors
Chen, Xiyang; Zheng, Jinglu; Yin, Li; Li, Yikai; Liu, Hongwen
- 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.
- Subjects
KNEE osteoarthritis; PATIENT safety; ADIPOSE tissues; RESEARCH funding; MESENCHYMAL stem cells; VISUAL analog scale; HYALURONIC acid; QUESTIONNAIRES; TREATMENT effectiveness; DESCRIPTIVE statistics; META-analysis; MAGNETIC resonance imaging; SYSTEMATIC reviews; MEDLINE; MEDICAL databases; BONE marrow transplantation; ONLINE information services; KNEE; DATA analysis software; CONFIDENCE intervals; UMBILICAL cord; RANGE of motion of joints; SYMPTOMS
- Publication
Journal of Orthopaedic Surgery & Research, 2024, Vol 19, Issue 1, p1
- ISSN
1749-799X
- Publication type
Article
- DOI
10.1186/s13018-024-04846-1