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The following is a summary of “Mesenchymal stem cells for chronic knee pain secondary to osteoarthritis: A systematic review and meta-analysis of randomized trials,” published in the May 2024 issue of Rheumatology by Sadeghirad et al.

A systematic search of MEDLINE, EMBASE, CINAHL, and Cochrane Central databases up to September 2023 was conducted to identify randomized trials involving patients with knee OA-related chronic pain randomized to receive MSC therapy versus placebo or standard care. Meta-analysis using random-effects models and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was employed to assess evidence quality.

About 16 trials involving 807 participants were included. At 3–6 months, MSC therapy likely resulted in minimal to no difference in pain relief (weighted mean difference [WMD] −0.74 cm on a 10 cm visual analog scale [VAS], 95% CI −1.16 to −0.33; minimally important difference [MID] 1.5 cm) and physical functioning (WMD 2.23 points on 100-point 36-item Short Form Survey [SF-36] physical functioning subscale, 95%CI −0.97 to 5.43; MID 10 points; both moderate certainty). By 12 months, MSC injection probably showed minimal to no difference in pain reduction (WMD −0.73 cm on a 10 cm VAS, 95%CI −1.69 to 0.24; moderate certainty) and potentially improved physical function (WMD 19.36 points on 100-point SF-36 PF subscale, 95%CI −0.19 to 38.9; low certainty). However, MSC therapy may increase the risk of adverse events overall (risk ratio [RR] 2.67, 95%CI 1.19 to 5.99; low certainty), including knee joint pain and swelling (RR 1.58, 95%CI 1.04 to 2.38; low certainty).

Intra-articular MSC injection for chronic knee pain related to OA likely provides minimal to no clinically significant improvement in pain relief or physical function.

Source: sciencedirect.com/science/article/pii/S1063458424012007