Knee osteoarthritis: stem cell therapy effective with or without platelet-rich plasma

  • Bastos R & al.
  • Knee Surg Sports Traumatol Arthrosc
  • 05/10/2019

  • Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A small randomized controlled trial (RCT) of intra-articular injection of culture-expanded mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) finds improvement in most pain, symptoms, and daily living outcomes, but not in range of motion (ROM), in patients with knee osteoarthritis (KOA).

Why this matters

  • This RCT is among the first investigations of MSCs±PRP.

Study design

  • Double-blind RCT of 47 patients with KOA, most with Kellgren-Lawrence grade III (41.1%).
  • Patients were randomly assigned to 1 of 3 groups:
    • Autologous bone marrow-derived culture-expanded MSCs.
    • Autologous bone marrow-derived culture-expanded MSCs+PRP.
    • Corticosteroid.
  • Main outcomes were improvement in 5 domains and global Knee Injury and Osteoarthritis Outcome Score (KOOS) and ROM.
  • Funding: None.

Key results

  • At 1 year vs baseline:
    • No improvement in ROM in any of the groups.
    • The control group only improved in 2 KOOS domains: pain (P=.029) and daily living function (P=.030).
    • The MSC group improved in 5 KOOS domains: symptoms (P=.010), pain (P=.008), daily living function (P=.003), sports/recreation (P=.001), QoL (P=.009); plus global KOOS score (P=.002).
    • The MSC+PRP group improved in 4 KOOS domains: symptoms (P=.025), pain (P<.001 daily living function sports plus global koos score>
    • All groups showed reduction in IL-10 levels.

Limitations

  • Small sample sizes.