Efficacy and safety of mesenchymal stem cell injections for patients with osteoarthritis: a meta-analysis and review of RCTs

Arch Orthop Trauma Surg. 2021 Jul;141(7):1241-1251. doi: 10.1007/s00402-020-03703-0. Epub 2021 Jan 28.


Introduction: Osteoarthritis (OA), which has a high incidence in the elderly, brings a huge economic burden to society. MSCs (Mesenchymal Stem Cells) have shown great multidirectional differentiation potential which are expected to treat OA, and numerous clinical trials have been conducted. However, the efficacy and safety of the MSCs still need to be further integrated and analyzed.

Materials and methods: We searched several databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, Ovid, and ScienceDirect) for assessing eligible trials that randomized controlled trials, hyaluronic acid as control, and MSCs injection to treat OA. Vitro studies and animal studies were excluded. Search terms were: "cartilage," "clinical trial," "mesenchymal," "stromal" and "stem cell", "osteoarthritis". The preliminary guidelines and study protocol were published online at PROSPERO.

Results: Many assessment scales could not be improved significantly after 6 months. However, most of the scales were significantly improved after 12 months, indicating that compared with hyaluronic acid, stem cells could relieve OA symptoms significantly. No serious adverse effect was found.

Conclusion: There are significant therapeutic effects on joint function, symptoms, and no permanent adverse effect has been found after stem cell treatment. It is promising to apply intro-articular injection of stem cells for OA to clinical application. More researches are needed to supplement present deficiencies.

Keywords: Adverse effects; Mesenchymal stem cells; Osteoarthritis; Therapy.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Humans
  • Mesenchymal Stem Cell Transplantation*
  • Osteoarthritis, Knee / therapy*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome