School of Medicine, Regenerative Medicine, Organ Procurement and Transplantation Multi- Disciplinary Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Department of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Stem Cell Rev Rep. 2024 Nov;20(8):2104-2123. doi: 10.1007/s12015-024-10768-6. Epub 2024 Aug 15.
Osteoarthritis (OA) is a prevalent musculoskeletal disease affecting middle-aged and elderly individuals, with knee pain as a common complaint. Standard therapy approaches generally attempt to alleviate pain and inflammation, using various pharmacological and non-pharmacological options. However, the efficacy of these therapies in long-term tissue repair remains debated. As an alternative, regenerative medicine offers a promising strategy, with decreased adverse event rates and increasing evidence of safety and efficacy. This review will outline current advances in regenerative medicine for knee OA, emphasizing outpatient clinic-based therapies that use orthobiological and non-biological products. Different strategies based on orthobiologics are discussed as potential regenerative options for the management of knee OA. Cell-free therapies including platelet-rich plasma, autologous anti-inflammatories, exosomes, human placenta extract, and mitochondrial transplantation are discussed, focusing on their potential for cartilage regeneration. Additionally, cell-based therapies with regenerative properties including bone marrow aspirate concentrate, adipose stromal vascular fraction, microfat, nanofat, stem cell therapy, and genetically modified cells as part of orthobiologics, are being investigated. Also, this study is looking into non-biological approaches such as using gold-induced cytokines, extracorporeal shockwave therapy, and ozone therapy. The mechanisms of action, effectiveness, and clinical applications of each therapy are being explored, providing insights into their role in the management of knee OA.
骨关节炎（OA）是一种常见的影响中老年人的肌肉骨骼疾病，以膝关节疼痛为常见症状。标准的治疗方法通常试图通过各种药理和非药理选择来缓解疼痛和炎症。然而，这些疗法在长期组织修复方面的疗效仍存在争议。作为替代方案，再生医学提供了一种有前途的策略，具有较低的不良事件发生率和越来越多的安全性和疗效证据。本综述将概述膝骨关节炎再生医学的最新进展，重点介绍基于门诊的使用orthobiologics 和非生物产品的治疗方法。讨论了基于 orthobiologics 的不同策略，作为膝骨关节炎管理的潜在再生选择。讨论了无细胞疗法，包括富含血小板的血浆、自体抗炎药、外泌体、人胎盘提取物和线粒体移植，重点是它们在软骨再生方面的潜力。此外，还研究了具有再生特性的基于细胞的疗法，包括骨髓抽吸浓缩物、脂肪基质血管部分、微脂肪、纳米脂肪、干细胞疗法和作为 orthobiologics 的一部分的基因修饰细胞，研究了它们在膝骨关节炎管理中的作用。本研究还探讨了非生物方法，如使用金诱导细胞因子、体外冲击波疗法和臭氧疗法。正在探索每种治疗方法的作用机制、有效性和临床应用，以了解它们在膝骨关节炎管理中的作用。
