Regenerative Potential of Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis and Chondral Defects: A Systematic Review and Meta-analysis

医学 间充质干细胞 荟萃分析 骨关节炎 再生医学 干细胞 病理 生物 替代医学 遗传学
作者
Bhargavi Maheshwer,Evan M. Polce,Katlynn Paul,Brady T. Williams,Theodore S. Wolfson,Adam B. Yanke,Nikhil N. Verma,Brian J. Cole,Jorge Chahla
出处
期刊:Arthroscopy [Elsevier BV]
卷期号:37 (1): 362-378 被引量:75
标识
DOI:10.1016/j.arthro.2020.05.037
摘要

Purpose To perform a systematic review and meta-analysis evaluating the effects of mesenchymal stem cells (MSCs) on cartilage regeneration and patient-reported pain and function. Methods A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using a PRISMA checklist. The Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (2008-2019), EMBASE (2008-2019), and MEDLINE (2008-2019) were queried in July 2019 for literature reporting use of stem cells to treat knee osteoarthritis or chondral defects. Data describing administered treatment, subject population, injection type, duration of follow-up, pain and functional outcomes, and radiographic and magnetic resonance imaging findings were extracted. Risk of bias was assessed using the Downs and Black scale. Meta-analyses adjusted for random effects were performed, calculating pooled effect sizes in terms of patient-reported pain and function, cartilage quality, and cartilage volume. Results Twenty-five studies with 439 subjects were identified. There was no significant difference in pain improvement between MSC treatment and controls (pooled standardized mean difference [SMD] = 0.23, P = .30). However, MSC treatment was significantly favored for functional improvement (SMD = 0.66, P < .001). There was improvement in cartilage volume after MSC treatment (SMD = 0.84, P < .001). Regarding cartilage quality, meta-analysis resulted in a small, nonsignificant effect size of 0.37 (95%, –0.03 to 0.77, P = .07). There was risk for potential bias among included studies, with 17 (68%) receiving either a grade of “poor” or “fair.” Conclusions The pooled SMD from meta-analyses showed statistically significant effects of MSC on self-reported physical function but not self-reported pain. MSCs provided functional benefit only in patients who underwent concomitant surgery. However, this must be interpreted with caution, as there was substantial variability in MSC composition and mode of delivery. MSC treatment provided significant improvement in cartilage volume but not cartilage quality. Preliminary data regarding therapeutic properties of MSC treatment suggest significant heterogeneity in the current literature, and risk of bias is not negligible. Level of Evidence II, Systematic Review and Meta-analysis To perform a systematic review and meta-analysis evaluating the effects of mesenchymal stem cells (MSCs) on cartilage regeneration and patient-reported pain and function. A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using a PRISMA checklist. The Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (2008-2019), EMBASE (2008-2019), and MEDLINE (2008-2019) were queried in July 2019 for literature reporting use of stem cells to treat knee osteoarthritis or chondral defects. Data describing administered treatment, subject population, injection type, duration of follow-up, pain and functional outcomes, and radiographic and magnetic resonance imaging findings were extracted. Risk of bias was assessed using the Downs and Black scale. Meta-analyses adjusted for random effects were performed, calculating pooled effect sizes in terms of patient-reported pain and function, cartilage quality, and cartilage volume. Twenty-five studies with 439 subjects were identified. There was no significant difference in pain improvement between MSC treatment and controls (pooled standardized mean difference [SMD] = 0.23, P = .30). However, MSC treatment was significantly favored for functional improvement (SMD = 0.66, P < .001). There was improvement in cartilage volume after MSC treatment (SMD = 0.84, P < .001). Regarding cartilage quality, meta-analysis resulted in a small, nonsignificant effect size of 0.37 (95%, –0.03 to 0.77, P = .07). There was risk for potential bias among included studies, with 17 (68%) receiving either a grade of “poor” or “fair.” The pooled SMD from meta-analyses showed statistically significant effects of MSC on self-reported physical function but not self-reported pain. MSCs provided functional benefit only in patients who underwent concomitant surgery. However, this must be interpreted with caution, as there was substantial variability in MSC composition and mode of delivery. MSC treatment provided significant improvement in cartilage volume but not cartilage quality. Preliminary data regarding therapeutic properties of MSC treatment suggest significant heterogeneity in the current literature, and risk of bias is not negligible.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
包包完成签到 ,获得积分10
刚刚
swx完成签到,获得积分10
1秒前
纯爱完成签到,获得积分10
1秒前
neao发布了新的文献求助10
1秒前
xunxunmimi完成签到,获得积分10
1秒前
2秒前
完美世界应助南瓜气气采纳,获得10
3秒前
3秒前
深情安青应助稳重向南采纳,获得10
3秒前
4秒前
wuzhizhongbin完成签到,获得积分10
4秒前
Lucas应助fksci采纳,获得10
5秒前
6秒前
6秒前
7秒前
7秒前
Hello应助哈哈哈采纳,获得10
7秒前
7秒前
7秒前
8秒前
研友_VZG7GZ应助火星上友易采纳,获得10
8秒前
平常的可乐完成签到 ,获得积分10
8秒前
小黄鸭发布了新的文献求助10
9秒前
9秒前
零几年完成签到,获得积分10
9秒前
szh123发布了新的文献求助10
10秒前
上官若男应助肖剑采纳,获得10
10秒前
10秒前
CodeCraft应助应夏山采纳,获得10
11秒前
领导范儿应助mm_zxh采纳,获得10
11秒前
11秒前
受伤幻桃发布了新的文献求助10
12秒前
Fran07发布了新的文献求助10
12秒前
1231发布了新的文献求助10
13秒前
hanlanx发布了新的文献求助10
13秒前
小二郎应助稳重向南采纳,获得10
13秒前
快乐难敌发布了新的文献求助10
13秒前
michi发布了新的文献求助10
13秒前
15秒前
whisper发布了新的文献求助10
15秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 360
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3971395
求助须知:如何正确求助?哪些是违规求助? 3516110
关于积分的说明 11180848
捐赠科研通 3251238
什么是DOI,文献DOI怎么找? 1795760
邀请新用户注册赠送积分活动 876012
科研通“疑难数据库(出版商)”最低求助积分说明 805228