Kader Nardeen, Asopa Vipin, Baryeh Kwaku, Sochart David, Maffulli Nicola, Kader Deiary
South West London Elective Orthopaedic Centre, Epsom, UK.
University of Salford, Manchester, UK.
Expert Opin Biol Ther. 2021 Aug;21(8):1035-1047. doi: 10.1080/14712598.2021.1872538. Epub 2021 Jan 19.
An ever-increasing number of clinics are offering purportedly 'regenerative' stem-cell treatments, although cell-based therapies may not primarily act as stem cells and have shown the ability to regenerate end-target tissues in some clinical studies only. We aim to systematically review the evidence for their use in soft-tissue sports injuries of the knee.
A search for articles pertaining to the use of preparations of, or containing, mesenchymal stem cells (MSCs) in human subjects in sports knee injuries yielded 14 relevant results for inclusion after screening: 7 used cultured MSCs, 5 bone marrow concentrate (BMC), and the remaining 2 evaluated stromal vascular fraction (SVF) and tenocyte-like-cells. Most studies were level 3 or lower (n = 9).
There is insufficient high-quality evidence for the use of cell-based therapies that demonstrates either ligamentous or tendinous healing, meniscal volume restoration, or post-traumatic osteoarthritis amelioration/regression. Methods of cell harvesting, preparation, and application are highly heterogenous. Efforts should be directed toward standardization of protocols and their reporting, starting with more basic scientific investigations of MSCs and their niche, as well as rigorous, large clinical RCTs adhering to the reporting principles set out by recent expert consensus.
越来越多的诊所提供所谓的“再生”干细胞治疗，尽管基于细胞的疗法可能并非主要通过干细胞发挥作用，且仅在一些临床研究中显示出能够再生终末靶组织的能力。我们旨在系统回顾其用于膝关节软组织运动损伤的证据。
检索关于在人类运动性膝关节损伤中使用间充质干细胞（MSC）制剂或含MSC的制品的文章，经筛选后有14篇相关结果纳入：7篇使用培养的MSC，5篇使用骨髓浓缩物（BMC），其余2篇评估了基质血管成分（SVF）和类成纤维细胞。大多数研究为3级或更低级别（n = 9）。
对于使用基于细胞的疗法来证明韧带或肌腱愈合、半月板体积恢复或创伤后骨关节炎改善/消退，目前高质量证据不足。细胞采集、制备和应用方法高度异质性。应致力于方案的标准化及其报告，首先要对MSC及其微环境进行更多基础科学研究，以及开展严格的、大型临床随机对照试验，并遵循近期专家共识提出的报告原则。
