Table I.
Summary of studies using MSCs to treat KOA patients.
| Author, year | Number of patients | Mean age (year) | BMI | Disease duration | Double blind | ITT | Outcome measure | Follow-up time (month) | Adverse events | Quality assessment | Ref. |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Single-arm, prospective follow-up studies | |||||||||||
| Buda et al, 2010 | 20 (12M, 8F) | NM | NM | ≥12 months | No | Yes | IKDC | 6, 12, 24 | None | 4a | (39) |
| Gobbi et al, 2011 | 15 (10M, 5F) | 48 (32–58) | 24.5±2.53 | NM | No | Yes | VAS, IKDC | 6, 12, 24 | None | 4a | (40) |
| Davatchi et al, 2011 | 4 (2M, 2F) | 57.7±5.0 | 30.25±4.86 | ≥7 years | No | Yes | VAS | 6 | None | 4a | (18) |
| Emadedin et al, 2012 | 6 (6F) | 53.8±8.9 | 31.6±4.2 | NM | No | Yes | VAS, WOMAC | 2, 6, 12 | None | 4a | (19) |
| Koh et al, 2013 | 18 (6M, 12F) | 54.6±7.8 | NM | ≥6 months | No | No | VAS, Lysholm | 24 | Marked pain in 1 patient | 4a | (20) |
| Turajane et al, 2013 | 5 (1M, 4F) | 57.2±1.92 | 25.36±4.46 | ≥3 months | No | Yes | VAS, WOMAC | 1,6 | None | 4a | (41) |
| Orozco et al, 2013 | 12 (6M, 6F) | 49±17.3 | NM | ≥6 months | No | Yes | VAS, WOMAC | 3, 6, 12, 24 | Local pain with discomfort in 6 patients | 4a | (42) |
| Author, year | Number of patients | Average age (year) | BMI | Disease duration | Double blind | ITT | Outcome measure | Follow-up time (month) | Adverse event | Quality assessment | Ref. |
| Kim et al, 2014 | 41 (17M, 24F) | 60.7 (53–80) | <30 | ≥12 months | No | Yes | VAS, IKDC | 3, 6, 12 | Joint swelling in 69 knees, pain in 31 knees | 4a | (43) |
| Koh et al, 2013 | 30 (5M, 25F) | 70.3 (65–80) | NM | ≥12 months | No | Yes | VAS, Lysholm | 3, 12, 24 | Slight pain in 3 patients | 4a | (44) |
| Gobbi et al, 2014 | 25 (16M, 5F) | 46.5±8.55 | 24.4±3.0 | ≥3 years | No | Yes | VAS, IKDC | 12, 24 | None | 4* | (45) |
| Quasi-experimental studies | |||||||||||
| Koh and Choi, 2012 | 50 (MSCs + PRP group: 8M, 17F; PRP group: 8M; 17F) | MSC group: 54.2±9.3; placebo group: 54.4±11.3 | NM | ≥12 months | No | Yes | VAS, Lysholm | 3, 12 | Marked pain with swelling in 1 patient | 5a | (46) |
| Koh et al, 2014 | 56 (Group 1: 8M, 13F; Group 2: 14M, 21F) | Group 1: 55.3±4.1; Group 2: 57.4±5.7 | Group 1: 26.7±3.1; Group 2: 26.3±3.0 | ≥12 months | No | No | IKDS | 12, 24 | None | 5a | (47) |
| Jo et al, 2014 | 18 (LDG: 1M, 2F; MDG: 0M, 3F; HDG: 2M, 10F) | LDG: 63±8.6 MDG: 65±6.6 HDG: 61±6.2 | LDG: 26±1.0 MDG: 28±2.1 HDG: 26±2.1 | ≥4 months | No | Yes | VAS, WOMAC | 3, 6 | Mild (LDG:3; MDG: 2; HDG:5) | 5a | (48) |
| Kim et al, 2014 | 54 (MSCs group: 14M, 23F; MSC + fibrin glue group: 8M, 9F) | MSCs group: 57.5±5.9; MSC + fibrin glue group: 57.7±5.8 | MSCs group: 26.3±3.2; MSC + fibrin glue group: 27.3±2.9 | ≥18 months | No | No | IKDC | 12, 24 | None | 5a | (49) |
| Randomized controlled trials | |||||||||||
| Varma et al, 2010 | 50 (AD: 25; AD + MSC: 25) | AD group: 48.20±5.13; AD + MSC: 50.67±5.38 | NM | NM | No | Yes | VAS | 3, 6 | None | 3b | (50) |
| Saw et al, 2013 | 50 (HAG: 7M, 17F; HA + PBSC group 10M, 15F) | HAG: 42±5.91 HA + PBSC: 38±7.33 | HA: 24.83±4.04 HA + PBSC: 24.91±4.15 | ≥12 months | No | No | IKDS | 6, 12, 24 | None | 3b | (51) |
| Wong et al, 2013 | 56 (HTO + MSC: 15M, 13F HTO: 14M, 14F) | HTO + MSC: 53 (36–54) HTO: 49 (24–54) | HTO + MSC: 23.81±2.17 HTO: 23.89±3.20 | NM | No | Yes | IKDS, Tegner, Lysholm | 6, 12, 24 | None | 3b | (52) |
| Vangsness et al, 2014 | 55 (LDG: 11M, 7F; HDG: 14M, 4F HAG: 13M, 6F) | LDG: 44.6±9.82 HDG: 45.6±12.42 HAG: 47.8±8 | LDG: 29.86±7.94; HDG: 29.09±5.91; HAG: 26.89± 4.05 | NM | Yes | No | VAS, Lysholm | 6, 12, 24 | Mild (LDG:18; HDG: 17; HAG: 17) | 5b | (53) |
MSC, mesenchymal stem cell; M, male; F, female; BMI, body mass index; ITT, intention-to-treat; HAG, hyaluronic acid group; PBSCs, peripheral blood stem cells; HTO, high tibial osteotomy; VAS, the visual analog scale; IKDC, International Knee Documentation Committee; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.
a
Quality scores derived from the Newcastle-Ottawa scale
b
quality scores derived from the Jadad scale; NM, not mentioned; LDG, low-dose group; MDG, mid-dose group; HDG, high-dose group; AD, arthroscopic debridement.