Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China.
Department of Joint Surgery, the Third Hospital of Jinan, Jinan, 250132, China.
J Orthop Surg Res. 2021 Jan 6;16(1):11. doi: 10.1186/s13018-020-02128-0.
Mesenchymal stromal cells (MSCs) are used as an emerging new option for the treatment of knee osteoarthritis (OA). However, their efficacy remains controversial across studies with different doses of MSCs and cell processing methods. We conducted this meta-analysis to assess the efficacy of MSCs in the treatment of knee OA.
Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, China), and CNKI (National Knowledge Infrastructure, China) databases were systematically reviewed. The pain level and function improvements were evaluated using visual analog scale (VAS), McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC). The pooled estimate was calculated with weighted mean difference (WMD) with 95% confidence intervals (95%CIs).
Nine RCTs involving 476 patients were included in this meta-analysis. The pooled estimate showed that the treatment of MSCs significantly reduced VAS, WOMAC pain, WOMAC stiffness, and WOMAC function scores at a long-term follow-up (12 or 24 months). However, for the IKDC and WOMAC total scores, MSCs also showed significant improvement in these outcomes, although this was not statistically significant when compared to the control.
Based on the current studies, our results suggested that MSCs were a promising option for the treatment of patients with knee OA. However, considering the potential limitations, more well-performed, large-scale RCTs are needed to verify our findings.
间充质基质细胞（MSCs）作为一种新兴的治疗膝骨关节炎（OA）的新选择，正在被广泛研究。然而，由于不同剂量的 MSC 和细胞处理方法的研究结果存在差异，其疗效仍存在争议。我们进行了这项荟萃分析，以评估 MSC 治疗膝骨关节炎的疗效。
系统检索了 PubMed、Embase、Web of Science、SinoMed（中国生物医学文献服务系统，中国）和 CNKI（中国国家知识基础设施，中国）数据库中发表的随机对照试验（RCTs）。使用视觉模拟量表（VAS）、麦克马斯特大学骨关节炎指数（WOMAC）和国际膝关节文献委员会（IKDC）评估疼痛水平和功能改善。采用加权均数差（WMD）及其 95%置信区间（95%CI）进行汇总估计。
本荟萃分析纳入了 9 项 RCT，共 476 例患者。汇总估计结果表明，MSC 治疗在长期随访（12 或 24 个月）时可显著降低 VAS、WOMAC 疼痛、WOMAC 僵硬和 WOMAC 功能评分。然而，对于 IKDC 和 WOMAC 总分，MSC 治疗也显示出这些结局的显著改善，但与对照组相比，这并不具有统计学意义。
根据目前的研究结果，我们的结论表明 MSC 是治疗膝骨关节炎患者的一种有前途的选择。然而，考虑到潜在的局限性，还需要更多设计良好、大规模的 RCT 来验证我们的发现。
