Intra-articular injection of culture-expanded mesenchymal stem cells with or without addition of platelet-rich plasma is effective in decreasing pain and symptoms in knee osteoarthritis: a controlled, double-blind clinical trial

Ricardo Bastos, Marcelo Mathias, Renato Andrade, Ronaldo J.F.C. Amaral, Vinicius Schott, Alex Balduino, Raquel Bastos, J. Miguel Oliveira, Rui L. Reis, Scott Rodeo, João Espregueira-Mendes

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78 Citations (Scopus)

Abstract

Purpose: To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). Methods: Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intra-articular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively. Results: The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of human interleukin-10 cytokine, from baseline to 12 months (p < 0.05). Conclusion: An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up. Level of evidence: II.

Original languageEnglish
Pages (from-to)1989-1999
Number of pages11
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume28
Issue number6
DOIs
Publication statusPublished - Jun 1 2020

Bibliographical note

Publisher Copyright:
© 2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

Funding

The authors would like to sincerely acknowledge ESHO Empresa de Serviços Hospitalares S.A and Keila Mara Cassiano.

FundersFunder number
ESHO Empresa de Serviços Hospitalares S.A
Keila Mara Cassiano

    ASJC Scopus Subject Areas

    • Surgery
    • Orthopedics and Sports Medicine

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