PDF(Pubmed)
Abstract：
OBJECTIVE: Implantation of mesenchymal stem cells (MSCs) is a potential cell-based modality for cartilage repair. Currently, its clinical use largely surrounds focal cartilage defect repair and intra-articular injections in knee osteoarthritis. The MSCs\' implantation efficacy as a treatment option for osteoarthritis remains contentious. This systematic review aims to evaluate studies that focused on MSCs implantation in patients with knee OA to provide a summary of this treatment option outcomes.
METHODS: A systematic search was performed in PubMed (Medline), Scopus, Cinahl, and the Cochrane Library. Original studies investigating outcomes of MSCs implantations in patients with knee OA were included. Data on clinical outcomes using subjective scores, radiological outcomes, and second-look arthroscopy gradings were extracted.
RESULTS: Nine studies were included in this review. In all included studies, clinical outcome scores revealed significantly improved functionality and better postoperative pain scores at 2-3 years follow-up. Improved cartilage volume and quality at the lesion site was observed in five studies that included a postoperative magnetic resonance imaging assessment and studies that performed second-look arthroscopy. No major complications or tumorigenesis occurred. Outcomes were consistent in both single MSCs implantation and concurrent HTO with MSCs implantation in cases with excessive varus deformity.
CONCLUSIONS: According to the available literature, MSCs implantation in patients with mild to moderate knee osteoarthritis is safe and provides short-term clinical improvement and satisfactory cartilage restoration, either as a standalone procedure or combined with HTO in cases with axial deformity. However, the evidence is limited due to the high heterogeneity among studies and the insufficient number of studies including a control group and mid-term outcomes.
METHODS: IV.
METHODS: A systematic search was performed in PubMed (Medline), Scopus, Cinahl, and the Cochrane Library. Original studies investigating outcomes of MSCs implantations in patients with knee OA were included. Data on clinical outcomes using subjective scores, radiological outcomes, and second-look arthroscopy gradings were extracted.
RESULTS: Nine studies were included in this review. In all included studies, clinical outcome scores revealed significantly improved functionality and better postoperative pain scores at 2-3 years follow-up. Improved cartilage volume and quality at the lesion site was observed in five studies that included a postoperative magnetic resonance imaging assessment and studies that performed second-look arthroscopy. No major complications or tumorigenesis occurred. Outcomes were consistent in both single MSCs implantation and concurrent HTO with MSCs implantation in cases with excessive varus deformity.
CONCLUSIONS: According to the available literature, MSCs implantation in patients with mild to moderate knee osteoarthritis is safe and provides short-term clinical improvement and satisfactory cartilage restoration, either as a standalone procedure or combined with HTO in cases with axial deformity. However, the evidence is limited due to the high heterogeneity among studies and the insufficient number of studies including a control group and mid-term outcomes.
METHODS: IV.
摘要：
目的：间充质干细胞（MSCs）的植入是一种潜在的基于细胞的软骨修复方式。目前,其临床应用主要围绕局灶性软骨缺损修复和膝关节骨性关节炎的关节内注射。作为骨关节炎治疗选择的MSCs植入功效仍存在争议。本系统综述旨在评估针对膝关节OA患者的MSCs植入的研究，以提供该治疗选择结果的总结。
方法：在PubMed（Medline）中进行了系统搜索，Scopus,Cinahl,还有Cochrane图书馆.纳入了研究膝关节OA患者MSCs植入结果的原始研究。使用主观评分的临床结果数据，放射学结果，并提取了第二次关节镜分级。
结果：本综述纳入了9项研究。在所有纳入的研究中，临床结局评分显示,在2~3年随访时,患者的功能和术后疼痛评分显著改善.在五项研究中观察到病变部位软骨体积和质量的改善，其中包括术后磁共振成像评估和进行二次关节镜检查的研究。无重大并发症或肿瘤发生。在过度内翻畸形的情况下，单个MSCs植入和同时进行HTO与MSCs植入的结果是一致的。
结论：根据现有文献，MSCs植入治疗轻中度膝骨关节炎是安全的，可提供短期临床改善和满意的软骨恢复，在轴向畸形的情况下，作为独立程序或结合HTO。然而,由于研究之间的高度异质性以及包括对照组和中期结局在内的研究数量不足,证据有限.
方法：IV.
方法：在PubMed（Medline）中进行了系统搜索，Scopus,Cinahl,还有Cochrane图书馆.纳入了研究膝关节OA患者MSCs植入结果的原始研究。使用主观评分的临床结果数据，放射学结果，并提取了第二次关节镜分级。
结果：本综述纳入了9项研究。在所有纳入的研究中，临床结局评分显示,在2~3年随访时,患者的功能和术后疼痛评分显著改善.在五项研究中观察到病变部位软骨体积和质量的改善，其中包括术后磁共振成像评估和进行二次关节镜检查的研究。无重大并发症或肿瘤发生。在过度内翻畸形的情况下，单个MSCs植入和同时进行HTO与MSCs植入的结果是一致的。
结论：根据现有文献，MSCs植入治疗轻中度膝骨关节炎是安全的，可提供短期临床改善和满意的软骨恢复，在轴向畸形的情况下，作为独立程序或结合HTO。然而,由于研究之间的高度异质性以及包括对照组和中期结局在内的研究数量不足,证据有限.
方法：IV.
