Umbilical Cord-Derived Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review.

BACKGROUND

The use of mesenchymal stem cells (MSCs) for the treatment of knee osteoarthritis (OA) has gained recent interest in the orthopaedics community.

PURPOSE

To review the literature to evaluate the efficacy of umbilical cord-derived MSCs in the treatment of OA of the knee joint.

STUDY DESIGN

Systematic review; Level of evidence, 4.

METHODS

We searched the PubMed, Cochrane Library, and Embase databases to identify studies with evidence levels from 1 to 4 that evaluated the clinical efficacy of human umbilical cord-derived MSC (hUC-MSC) injections for knee OA. The search phrase used was "umbilical cord knee osteoarthritis." In the studies reviewed, patients were assessed based on the macroscopic International Cartilage Regeneration & Joint Preservation Society (ICRS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the subjective International Knee Documentation Committee (IKDC) score.

RESULTS

A total of 7 studies met inclusion criteria, including 385 patients undergoing injection of hUC-MSCs (mean age, 59.7 years). The mean follow-up was 23.4 months. Weighted averages of the WOMAC, macroscopic ICRS, subjective IKDC, and VAS scores all showed improvement from before to after treatment. No severe adverse reactions were recorded.

CONCLUSION

Patients undergoing treatment of knee OA with hUC-MSCs might be expected to experience improvements in clinical outcomes. Additional high-quality randomized studies are needed to better determine the efficacy of hUC-MSC for the treatment of knee OA.