Hohmann Erik, Keough Natalie, Stokes Daniel, Frank Rachel, Rodeo Scott
Medical School, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
University of Warwick, Coventry, UK.
Eur J Orthop Surg Traumatol. 2025 May 23;35(1):214. doi: 10.1007/s00590-025-04322-4.
To perform a systematic review and meta-analysis of randomized and comparative studies comparing mesenchymal stromal cells other orthobiological injections for patients with knee osteoarthritis.
Systematic review of Medline, Embase, Scopus, and Google Scholar, including all level 1-3 from 2014 to 2024. Validated scores (VAS, KOOS, Lysholm, IKDC) were included as outcome measures. Risk of bias was assessed using the Cochrane Collaboration's tools. The GRADE system was used to assess the quality of the body of evidence and the modified Coleman Methodology score was used to assess study quality. Heterogeneity was assessed using χ and I statistics.
Ten studies were included; all published in English between 2019 and 2023, encompassing a total of 563 cases (281 treated with MSCs and 282 with other biologics). Two studies had a high risk of bias, one had some bias, and seven had a low risk of bias. Publication bias was detected (Egger's test 3.26447; p = 0.007). The pooled estimates revealed significant differences favoring MSCs for VAS scores at 3, 6, and 12 months. For KOOS pain and symptoms, significant differences were observed at 3 and 6 months.
The results of this meta-analysis demonstrated a significant effect of adipose and bone marrow-derived stromal cell injections on pain reduction at all assessed time points, and showed superiority over other non-surgical treatment options. These differences were not reflected in clinical and functional outcomes, indicating that the observed reduction in pain did not correspond to substantial improvements in knee functionality.
对比较间充质基质细胞与其他矫形生物注射剂治疗膝关节骨关节炎患者的随机对照研究和比较研究进行系统评价和荟萃分析。
对Medline、Embase、Scopus和谷歌学术进行系统评价，纳入2014年至2024年所有1 - 3级研究。将经过验证的评分（视觉模拟评分法、膝关节损伤和骨关节炎疗效评分、Lysholm评分、国际膝关节文献委员会评分）作为结局指标。使用Cochrane协作网工具评估偏倚风险。采用GRADE系统评估证据体质量，采用改良的科尔曼方法评分评估研究质量。使用χ²和I²统计量评估异质性。
纳入10项研究；均于2019年至2023年间以英文发表，共涉及563例病例（281例接受间充质基质细胞治疗，282例接受其他生物制剂治疗）。两项研究存在高偏倚风险，一项存在一定偏倚，七项存在低偏倚风险。检测到发表偏倚（Egger检验3.26447；p = 0.007）。汇总估计显示，在3个月、6个月和12个月时，间充质基质细胞在视觉模拟评分法评分方面有显著优势。对于膝关节损伤和骨关节炎疗效评分的疼痛和症状，在3个月和6个月时观察到显著差异。
这项荟萃分析的结果表明，在所有评估时间点，脂肪和骨髓来源的基质细胞注射对减轻疼痛有显著效果，且优于其他非手术治疗选择。这些差异未反映在临床和功能结局中，表明观察到的疼痛减轻并未对应膝关节功能的实质性改善。
