Background
Materials and methods
Results
MSCs | Publication | Study type | Treatment | Additional information | Pathology |
N patients | Follow-up | Results |
---|---|---|---|---|---|---|---|---|
Cultured BMSCs | Davatchi [22] 2015 Int Journal of Rheum Disease | Case series | IA injection | Previous study update | Knee OA | 3 | 60 months | Still significant improvement at 5 years, but gradual worsening after 6-month follow-up |
Vega [26] 2015 Transplantation | RCT | IA injection | Allogeneic BMSCs | Knee OA | 15 BMSCs 15 HA | 12 months | Significant better functional and cartilage quality improvements in MSCs group vs. control | |
Sol Rich [18] 2015 J Stem Cell Res Ther | Case series | IA injection | Knee OA | 12 | 24 months | Excellent clinical and quantitative MRI outcome measures at 2 years | ||
Vangsness [25] 2014 JBJS Am | RCT | IA injection | Allogeneic BMSCs After medial meniscectomy | Knee OA | 18 low-dose MSCs + HA 18 high-dose MSCs + HA 19 HA | 24 months | Knee pain improvement and evidence of meniscus regeneration at MRI for both doses vs. control | |
Orozco [21] 2014 Transplantation | Case series | IA injection | Previous study update | Knee OA | 12 | 24 months | Pain improvement at 12 months maintained at 24 months. The quality of cartilage further improved at MRI at 24 months | |
Wong [24] 2013 Arthroscopy | RCT | IA injection | Comb HTO + MFX and post-op injection | Knee OA | 28 BMSCs + HA 28 HA | 24 months | BMSCs i.a. injection produced superior clinical and MRI outcomes at 24 months | |
Ricther [35] 2013 Foot & Ankle | Case series | Surgical delivery | MAST Collagen membrane | Ankle chondral defects | 25 | 24 months | No adverse events. Clinical scores improvement Positive findings at histology | |
Orozco [22] 2013 Transplantation | Case series | IA injection | Knee OA | 12 | 12 months | No safety issues. Rapid and progressive clinical improvement at 12 months 11/12 patients increased cartilage quality at MRI | ||
Lee [23] 2012 Ann Accad Med Singapore | Comparative | IA injection | Knee cartilage defects | 35 MFX + BMSCs + HA 35 BMSCs + periosteal patch | 24 months | MFX + BMSCs + HA had comparable results vs. BMSCs + periosteal patch, but lower invasivity | ||
Emadedin [19] 2012 Arch Iran Med | Case series | IA injection | Knee OA | 6 | 12 months | No local or systemic adverse events. Decreased pain, improved function and walking distance 3/6 increased cartilage thickness at MRI | ||
Kasemkijwattana [29] 2011 J Med Assoc Thai | Case report | Surgical delivery | MAST Collagen membrane | Knee cartilage defects | 2 | 31 months | Significant clinical improvement Good filling, tissue stiffness, and integration at 2nd look | |
Davatchi [17] 2011 Int J Rheum Dis | Case series | IA injection | Knee OA | 4 | 12 months | Encouraging clinical results no X-Rays improvement | ||
Haleem [28] 2010 Cartilage | Case series | Surgical delivery | MAST PRF as scaffold | Knee cartilage defects | 5 | 12 months | 5/5 symptoms improvement Complete defect filling and surface congruity with native cartilage in 3/5 at MRI | |
Nejadnik [34] 2010 AJSM | Comparative | Surgical delivery | BMSCs + periosteal flap | Knee cartilage defects | 36 ACI 36 BMSCs + periosteal flap | 24 months | Comparable improvement in quality of life, health, and sport activity. M better than F, older than 45 years lower improvement only in ACI group. | |
Centeno [16] 2008 Pain Physician | Case report | IA injection | Knee cartilage defects | 1 IA BMSCs + 2 weekly platelet lysate IA injections | 24 months | Improvement of range of motion and pain scores. Significant cartilage and meniscus growth at MRI | ||
Kuroda [30] 2007 Osteoarthritis & Cartilage | Case report | Surgical delivery | BMSCs + collagen gel + periosteum | Knee cartilage defects | 1 | 12 months | Hyaline-like tissue regeneration, improvement in clinical symptoms and return to previous activity level | |
Wakitani [31] 2007 J Tissue Eng Regen Med | Case report | Surgical delivery | BMSCs + collagen gel + periosteum or synovium | Knee cartilage defect patella | 3 | 17–27 months | Improvement in clinical symptoms maintained over time. Fibrocartilaginous tissue at histology | |
Adachi [27] 2005 J Rheumatol | Case report | Surgical delivery | MAST Hydroxyapatite ceramic | Knee osteochondral defect | 1 | Cartilage-like and bone tissue regeneration at 2nd look arthroscopy | ||
Wakitani [32] 2004 Cell Transplant | Case report | Surgical delivery | BMSCs + collagen gel + periosteum | Knee cartilage defect Patella | 2 | 5 years | Short-term clinical improvement, then stable at 24 months fibrocartilage defect filling | |
Wakitani [33] 2002 Osteoarthritis & Cartilage | Comparative | Surgical delivery | Collagen gel sheet + periosteum | Knee OA | 12 BMSCs + HTO 12 cell-free control + HTO | 16 months | Comparable clinical outcomes, but better arthroscopic and histological score in cell-transplanted group | |
BM Concentrate | Gobbi [47] 2015 Cartilage | Comparative | Surgical delivery | MAST HA matrix | Knee cartilage defects patellofemoral | 19 MACT 18 BMC | 3 years | Significant scores improvement in both groups. Better IKDC subj for BMC. MACI: trochlea better than patella; BMC: site n.s. Better filling at MRI for BMC |
Buda [40] 2015 Arch Orthop Trauma Surg | Case series | Surgical delivery | MAST HA matrix | OLTs and ankle OA | 56 | 36 months | Clinical outcome improvement at 12 months, further increase at 24 months and lowering trend at 36 months Higher BMI and OA degree had worse results | |
Buda [39] 2015 Cartilage | Case series | Surgical delivery | MAST HA matrix | Ankle osteochondral lesions (hemophilic patients) | 5 | 24 months | Clinical improvement at 2 years. 3 patients back to sports. Signs of cartilage and bone tissue regeneration at MRI. No radiographic joint degeneration progression | |
Buda R [43] 2015 Int Orthop | Comparative | Surgical delivery | MAST HA matrix + PRF | OLTs | 40 ACI 40 BMC | 48 months | ACI and MAST was equally effective for the treatment of OLT. MAST preferred for the 1 step procedure, and lower costs | |
Gobbi [50] 2014 AJSM | Case series | Surgical delivery | MAST Collagen membrane | Knee chondral defects | 25 | 3 years | Significant scores improvement Older than 45 and smaller or single lesions showed better outcomes. Good implant stability and complete filling at MRI. | |
Cadossi [44] 2014 Foot Ankle Int | RCT | Surgical delivery | MAST HA matrix | OLTs | 15 BMDCs + HA + PEMF 15 BMDCs + HA | 12 months | Biophysical stimulation started soon after surgery aided patient recovery leading to pain control and a better clinical outcome with these improvements lasting more than 1 year after surgery | |
Buda [41] 2014 Joints | Case series | Surgical delivery | MAST HA/collagen powder matrix + PRF | OLTs | 41 BMAC + HA + PRF 23 BMAC + collagen powder + PRF | 53 months | Significant clinical improvement, gradual decrease after 24+ months | |
Skowronski [51] 2013 Orthop Traumatol Rehabil | Case series | Surgical delivery | MAST Collagen membrane | Knee chondral defects | 54 | 5 years | Improvement in clinical scores in 52/54 patients without complications After 5 years n.s. deterioration in 3 patients | |
Giannini [38] 2013 AJSM | Case series | Surgical delivery | MAST HA membrane or collagen powder + PRF | OLTs | 49 | 24–48 months | Good clinical results at 24 months, then significant decrease at 36 and 48 months. T2 mapping similar to native hyaline cartilage and correlate with the clinical results | |
Buda [46] 2013 Muskuloskeletal Surg | Case series | Surgical delivery | MAST HA matrix | OLKs | 30 | 29 months | Good clinical outcome osteochondral regeneration at control MRI and biopsies | |
Gigante [48] 2012 Arhtroscopy Technique | Case report | Surgical delivery | MAST Collagen membrane + MFX | Knee chondral defects | 1 | 24 months | Pain free at 6 months, still asymptomatic at 24 months Positive MRI tissue appearance at 12 months | |
Gigante [49] 2011 Int J Immunopathol Pharmacol | Case series | Surgical delivery | MAST collagen membrane | Knee chondral defects | 5 | 12 months | Patients asymptomatic Nearly normal arthroscopic appearance and satisfactory repair tissue at 12 months | |
Giannini [42] 2010 Injury | Comparative | Surgical delivery | MAST HA matrix + PRF | OLTs | 10 ACI open 46 arthroscopic MACT 25 arthroscopic MAST | 36 months | Similar clinical improvement among groups. Good restoration of the cartilaginous layer with hyaline-like characteristics at MRI and histology | |
Varma [36] 2010 J Indian Med Assoc | Comparative | IA injection | Augmentation to debridement | Knee OA | 25 Debridement + BMC 25 Debridement alone | 6 months | BMC: higher improvement in symptoms, function, and quality of life | |
Buda [45] 2010 JBJS Am | Case series | Surgical delivery | MAST HA matrix + PRF | OLKs | 20 | 24 months | Significant clinical improvement at 12 and 24 months. Associated procedures delayed recovery. Satisfactory MRI findings in 80 % of patients | |
Giannini [37] 2009 Clin Orthop Rel Res | Case series | Surgical delivery | MAST HA matrix or collagen powder + PRF | OLTs | 48 | 24 months | Clinical improvement Regenerated tissue in various degree of remodeling, none had complete hyaline-like features at histology | |
PBSCs | Fu [55] 2014 Knee | Case report | Surgical delivery | PBSCs + autologous Periosteal flap + patellofemoral realignment | Knee chondral defects | 1 | 7.5 years | Patient returned to competitive kickboxing Smooth surface 8 months after surgery Significant clinical and MRI improvements |
Turajane [53] T 2013 J Med Assoc Thai | Case series | IA injection | PBSCs + GFs addition/preservation + HA + microdrilling | Knee OA | 5 | 6 months | Improvement in all clinical scores without adverse events | |
Saw [54] 2013 Arthroscopy | RCT | IA injection | Subchondral drilling PBSCs + HA vs. HA 5 IA injections post-op 3 more IA injections after 6 months | Knee chondral defects | 25 drilling + (PBSCs + HA) 25 drilling + HA | 2 years | Comparable significant clinical improvement for both groups PBSCs + HA had both MRI and histology superior vs. control group | |
Skowronski [56] 2012 Orthop Traumatol Rehabil | Case series | Surgical delivery | PBSCs covered by collagen membrane | Knee chondral defects | 52 | 6 years | No adverse events Improvement in all clinical scores at 12 months. Poor outcomes in 2 patients at 12 months At 72 months minor deterioration in 2 more patients | |
Saw [52] 2011 Arthroscopy | Case series | IA injection | Subchondral drilling + 5 weekly IA injections | Knee chondral defects | 5 | 10–26 months | No adverse events hyaline cartilage regeneration at histology | |
BMC vs. PBSCs | Skowronski [77] 2013 Orthop Traumatol Rehabil | Comparative | Surgical delivery | PBSCs vs. BMC covered by collagen membrane | OLKs | 21 BMC 25 PBSCs | 5 years | Superior results in PBSCs group: good cartilaginous surface and integration. Slight clinical scores decrease in both groups at 60 months |
SDSCs | Sekiya [76] 2015 Clin Orthop Relat Res | Case series | Surgical delivery | Cultured cells Scaffold free | Knee chondral defects | 10 | 48 months | Significant clinical improvement Positive findings at MRI, and hyaline like in 3/4 at histology |
ADSCs | Kim [71] 2015 AJSM | Comparative | Surgical delivery vs. IA injection | Subcutaneous fat SVF on FG scaffold vs. PRP-SVF injection | Isolated focal defects in knee OA | 20 SVF-FG 20 SVF-PRP | 28.6 months | Significant improvement in both groups. Better clinical results at final f-up and 2nd look appearance at 12 months for SVF-FG. No. of cells correlated with outcomes only for injective group |
Kim [72] 2015 Osteoarthritis Cartilage | Case series | Surgical delivery | Subcutaneous fat SVF + FG scaffold | Isolated focal defects in OA knee | 20 | 27.9 months | Significant clinical and MRI scores improvement MRI correlates with clinical outcomes | |
Michalek [67] 2015 Cell Transplant | Case series | IA injection | Subcutaneous fat SVF | OA (various joints) | 1114 | 17.2 months | No adverse effects, safe, cost-effective Clinical improvement at 3–12 months. Follow-up at 12 months: 63 % patients had ≥75 % score improvement 91 % patients had ≥50 % score improvement Slower healing for obese and worse OA | |
Koh [74] 2015 Arthroscopy | RCT | Surgical delivery | Subcutaneous fat MFX + FG + SVF vs. MFX | Knee chondral defects | 40 MFX + SVF-FG 40 MFX | 27.4 months | KOOS pain and symptoms better for SVF vs. control 2nd look: complete coverage 65 vs. 45 % SVF better MRI scores | |
Kim [73] 2015 AJSM | Case series | Surgical delivery | Subcutaneous fat SVF + FG | Isolated Focal defects in OA knee | 49 | 26.7 months | 74.5 % good/excellent results Patient age >60 years or lesion size >6.0 cm2 are predictors of clinical failure | |
Jo [59] 2014 Stem cell | Case series | IA injection | Cultured subcutaneous Phase I: low dose (1.0 × 107) vs. mid-dose (5.0 × 107) vs. high dose (1.0 × 108) Phase II: 18 patients received only high dose | Knee OA | Phase I: 9 Phase II: 18 | 6 months | High-dose was more effective for knee function improvement MRI: decreased defect size and improved cartilage volume No adverse events related to cell dose | |
Kim [69] 2014 AJSM | Comparative | IA injection | Subcutaneous fat SVF + marrow stimulation vs. marrow stimulation | OLTs | 24 marrow stim + SVF 26 marrow stimulation | 21.9 months | All clinical and MRI scores in SVF group improved significantly with respect to marrow stimulation alone SVF gave better outcomes for patients older than 46.1 years, lesion size >152.2 mm2, or in presence of subchondral cysts | |
Kim [71] 2014 AJSM | Comparative | Surgical delivery | Subcutaneous fat SVF local adherent vs. SVF + FG | Isolated focal defects in OA knee | 17 FG 37 scaffold-free | 28.6 months | Both comparable clinical improvement 2nd look arthrosocopy at 12.3 months f-up: better ICRS scores for FG group | |
Bui [62] 2014 Biomed Res Ther | Case series | IA injection | Subcutaneous fat SVF + PRP | Knee OA | 21 | 8.5 months | Significant clinical scores improvement. No side effects. MRI: increased cartilage thickness | |
Koh [70] 2014 AJSM | Case series | Surgical delivery | Subcutaneous fat SVF | Isolated focal defects in knee OA | 35 | 26.5 months | Clinical improvement 76 % abnormal repair tissue at 2nd look arthroscopy (12.7 months f-up) Better outcomes if size <5.4 cm2 and/or BMI < 27.5 | |
Koh [74] 2014 Arthroscopy | RCT | IA injection | Subcutaneous fat HTO + PRP vs. HTO + PRP + SVF | Knee OA | 23 HTO + PRP + SVF 21 HTO + PRP | 24 months | SVF produced better improvement of KOOS pain and symptoms and VAS pain Fibrocartilage coverage SVF 50 vs. 10 % control | |
Pak [61] 2013 BMC Musculoskelet Disord | Case series | IA injection | Subcutaneous fat SVF + PRP | OA (various joints) | 91 | 26.7 months | SVF/PRP injections are safe Clinical improvement knee and hip | |
Kim [68] 2013 AJSM | Comparative | IA injection | Subcutaneous fat SVF + PRP | Isolated defect in ankle OA | 35 MFX 30 MFX + SVF | 21.8 months | Clinical improvement both groups SVF group better results, especially applied to Tegner score Large lesion and/or subchondral cysts affected outcomes only for MFX alone | |
Koh [65] 2013 KSSTA | Case series | IA injection | Subcutaneous fat SVF + PRP | Knee OA | 30 | 24 months | Significant clinical improvement 14/16 (87.5 %) of 2nd look arthroscopy within 24 months improved or maintained cartilage status. Further clinical improvement 24 vs. 12 months | |
Koh [64] 2013 Arthroscopy | Case series | IA injection after debridement | Fat pad SVF + PRP | Knee OA | 18 | 24 months | function and pain improvement. Womac and MRI correlate with cell no. Better if OA ≤ 3 | |
Koh [63] 2012 Knee | Comparative | IA injection After debridement | Fat pad SVF + PRP | Knee OA | 25 debridement + SVF-PRP 25 debridement | 12 months min | Both improved scores. SVF performed better in <55 years and OA ≤ 3 (ICRS) | |
Pak [60] 2011 J Med Case Rep | Case report | IA injection | Subcutaneous fat SVF + PRP + low dose dexamethasone | Knee OA | 2 | 3 months | Clinical improvement Significant positive changes at MRI |