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间充质干细胞注射治疗膝骨关节炎的疗效与安全性:一项系统评价与荟萃分析

Efficacy and safety of mesenchymal stem cell injections for knee osteoarthritis: A systematic review and meta-analysis.

作者信息

Zhang Xinguang, Cui Cunbao, Lin Feng

机构信息

Department of Joint Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

出版信息

J Res Med Sci. 2024 Sep 30;29:55. doi: 10.4103/jrms.jrms_515_23. eCollection 2024.

Abstract

BACKGROUND

There have not been any clear studies on the use of mesenchymal stem cells (MSCs) to treat osteoarthritis (OA) in the knee.

MATERIALS AND METHODS

This study investigates the effects of different MSC dosages on pain alleviation in individuals with OA in the knee by conducting a meta-analysis of existing randomized controlled trials. Electronic resources such as Google Scholar, PubMed, Cochrane Library, and Web of Science were searched up until June 2023. Treatment effect sizes were computed using the knee osteoarthritis outcome score (KOOS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Knee Society Score (KSS). Random or fixed effect models were applied to aggregate the data. We performed a subgroup analysis according to dosage level. The heterogeneity of the research was investigated using the Chi-square test and the I2 index.

RESULTS

The meta-analysis included 26 studies with a total sample size of 739 patients. A significant reduction in pain was observed 1 year and 2 years following the injection of MSCs into the injured joint, as indicated by the Visual Analogue Scale, WOMAC, KOOS, and KSS indexes (P < 0.05). Patients on MSCs reported much reduced pain after 1 and 2 years compared to the control group (P < 0.05). Subgroup and meta-regression analyses revealed no statistically significant variations in the effectiveness of MSC dosage (P < 0.05). The studies did not report any adverse effects.

CONCLUSION

Different dosages of MSCs had the same pain-relieving effects on patients with OA in the knee. MSC injections were safe and beneficial in such cases.

摘要

背景

关于使用间充质干细胞(MSC)治疗膝关节骨关节炎(OA),尚未有明确的研究。

材料与方法

本研究通过对现有随机对照试验进行荟萃分析,调查不同MSC剂量对膝关节OA患者疼痛缓解的影响。检索了谷歌学术、PubMed、Cochrane图书馆和科学网等电子资源,截止到2023年6月。使用膝关节骨关节炎结局评分(KOOS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及膝关节协会评分(KSS)计算治疗效应大小。应用随机或固定效应模型汇总数据。我们根据剂量水平进行了亚组分析。使用卡方检验和I²指数研究研究的异质性。

结果

荟萃分析纳入了26项研究,总样本量为739例患者。视觉模拟量表、WOMAC、KOOS和KSS指数表明,在将MSC注入受伤关节后1年和2年,疼痛显著减轻(P < 0.05)。与对照组相比,接受MSC治疗的患者在1年和2年后报告疼痛明显减轻(P < 0.05)。亚组和荟萃回归分析显示,MSC剂量的有效性没有统计学上的显著差异(P < 0.05)。这些研究未报告任何不良反应。

结论

不同剂量的MSC对膝关节OA患者具有相同的止痛效果。在这种情况下,MSC注射是安全且有益的。

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