Clinical efficacy and cartilage repair effect of mesenchymal stem cells intra-articular injection for knee osteoarthritis: a meta-analysis of randomized control trials

Abstract

Objective \nTo assess the clinical efficacy and cartilage repair effect of mesenchymal stem cells (MSCs) intra-articular injection for knee osteoarthritis(KOA). \n \n \nMethods \nThe databases, including Cochrane library, PubMed, Embase (via Ovid), CNKI and Wanfang, were searched from inception to March 2019. The clinical randomized controlled trials (RCTs) of MSC-based therapy in KOA were conducted. Two independent reviewers selected the studies and extracted information according to the inclusion and exclusion criteria. The quality was assessed by Cochrane Handbook s risk of bias tool. The Meta-analysis was conducted by Revman 5.3 software. I2 was used for heterogeneity test, and random effects model was used for statistical analysis. Based on the inverse-variance method, the Dersimonian & Laird method was used to introduce correction factors to correct the weights and then calculate the combined effect amount and its 95% confidence interval (CI) . \n \n \nResults \nFifteen eligible clinical trials were included in this Meta-analysis, with a total of 576 patients. Compared with the control group, our study showed that the Visual analogue score (VAS) [MD=-15.51, 95%CI(-24.29, -6.74), P=0.000 5], Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score [MD=-11.08, 95%CI (-16.78, -5.38), P=0.000 1], and Lequesne index [MD=-8.45, 95%CI(-15.11, -1.80), P=0.01] were significantly decreased in the MSCs treatment group. However, there was no statistical significance in Lysholm knee score and MRI evaluation results (P>0.05). \n \n \nConclusion \nThis Meta-analysis has demonstrated that intra-articular injection of MSCs has good efficacy and safety in pain control and functional improvement in patients with KOA. But the results of the study do not show evidence of MSCs in repairing damaged cartilage. \n \n \nKey words: \nOsteoarthritis;\xa0Stem cells;\xa0Cartilage;\xa0Meta-analysis