Research Article

The Effectiveness and Safety of Mesenchymal Stem Cells in the Treatment of Osteoarthritis: A Systematic Review and Meta-analysis of 28 Randomized Controlled Trials

Table 1

The characteristics of the included studies.

StudyTrial registration numberCountryBlindSample size (female/male)InterventionOriginDosageRoute of medicationRelevant outcomesMean age (years)Follow-up
Trial groupControl groupTrial groupControl groupTrial groupControl group

Kuah et al. [24]ACTRN12615000439549AustraliaDouble-blind16 (5/11)4 (3/1)MSC+placeboPlacebo (cell culture media and cryopreservative)Human adipose tissuea: cells; b: cellsIntra-articular injectionWOMAC, VAS, adverse eventsLow: ; high: 12 months
Wang et al. [25]ChinaNot known18 (8/10)18 (7/11)MSC+sodium hyaluronateSodium hyaluronateHuman umbilical cord cellsIntra-articular injectionWOMAC45-6342-696 months
Gupta et al. [26]NCT01453738IndiaDouble-blind20 (15/5)10 (10/0)MSC+placeboPlacebo (Plasmalyte A)Human bone marrowa: cells; b: cellsIntra-articular injectionVAS, adverse eventsa: ; b: 12 months
Yang et al. [27]ChinaNot known28 (22/6)16 (11/5)MSC+sodium hyaluronateSodium hyaluronateHuman umbilical corda: cells; b: cellsIntra-articular injectionVAS, adverse eventsa: ; b: 12 months
Vega et al. [28]NCT01586312SpainBlind for participants15 (9/6)15 (10/5)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrow cellsIntra-articular injectionVAS, Lequesne, adverse events12 months
Hernigou et al. [29]FranceNot known30 (18/12)30 (18/12)MSC+total knee arthroplastyTotal knee arthroplastyHuman bone marrow cellsIntra-articular injectionAdverse events, other clinical indicators18-418-16 years
Hou et al. [30]ChinaNot known92 (52/40)88 (50/38)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrowNot knownIntra-articular injectionWOMAC6 months
Lamo-Espinosa et al. [31, 32]NCT02123368SpainNot known20 (8/12)10 (3/7)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrowa: cells b: cellsIntra-articular injectionWOMAC, VAS, adverse eventsa: 65.9 (59.5, 70.6); b:57.8 (55.0, 60.8)60.3 (55.1, 61.1)4 years
Lu et al. [33]ChinaNot known40 (26/14)40 (27/13)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrowNot knownIntra-articular injectionWOMAC, adverse events12 months
Gan et al. [34]ChinaNot known6 (5/1)6 (4/2)MSC+sodium hyaluronateSodium hyaluronateHuman umbilical cordNot knownIntra-articular injectionWOMAC, Lequesne12 months
Vangsness et al. [35]NCT00225095The USDouble-blind36 (not kwon)19 (not kwon)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrowa: cells; b: cellsIntra-articular injectionVAS, adverse events2 years
Tan et al. [34]ChinaNot known36 (26/10)36 (27/9)MSC+arthroscopy cleanupArthroscopy cleanupHuman bone marrow cellsIntra-articular injectionLequesne12 months
Wong et al. [36]The USNot known28 (13/15)28 (14/14)MSC+sodium hyaluronateSodium hyaluronateHuman bone marrow cellsIntra-articular injectionOther clinical indicators36-5424-542 years
Xu et al. [37]ChinaNot known20 (not kwon)20 (not kwon)MSC+arthroscopic surgery+sodium hyaluronateArthroscopic surgery+sodium hyaluronateHuman bone marrowNot knownIntra-articular injectionWOMAC44-743 years
Matas et al. [38]NCT02580695ChileDouble-blind18 (11/7)8 (5/3)MSC+sodium hyaluronateSodium hyaluronateHuman umbilical corda: cells; b: cellsIntra-articular injectionWOMAC, VAS, adverse eventsa: b: 54.8±4.512 months
Ha et al. [39]ChinaNot known89 (60/29)86 (63/23)a: MSC+platelet-rich plasma v.s. platelet-rich plasma; b: MSC v.s. sodium hyaluronate+triamcinolone acetonideHuman umbilical cord cellsIntra-articular injectionVAS, adverse eventsa: v.s. ; b: v.s. 12 months
Lu et al. [40]NCT02162693ChinaDouble-blind26 (23/3)26 (23/3)MSC+sodium hyaluronateSodium hyaluronateHuman adipose tissue cellsIntra-articular injectionWOMAC, VAS, adverse events12 months
Zhang et al. [41]NCT03955497ChinaNot known14 (9/5)14 (8/6)MSC+high tibial osteotomyHigh tibial osteotomyHuman adipose tissueNot knownIntra-articular injectionWOMAC, VAS12 months
Liang et al. [42]ChinaNot known26 (not known)MSCPlaceboHuman bone marrow cellsIntra-articular injectionWOMAC, adverse events40-654 weeks
Zhou [43]ChinaNot known54 (not known)54 (not known)MSC+sodium hyaluronateConventional therapyNot knownNot knownIntra-articular injectionWOMAC, VAS3 months
Freitag et al. [44]ACTRN12614000814673AustraliaNot known20 (9/11)10 (5/5)MSCConventional therapyHuman adipose tissuea: cells (single injection); b: cells (two injection)Intra-articular injectionWOMAC, adverse eventsa: ; b: 6 months
Lee et al. [45]South KoreaDouble-blind12 (9/3)12 (9/3)MSCNormal salineHuman adipose tissue cellsIntra-articular injectionWOMAC, VAS, adverse events6 months
Garza et al. [46]NCT02726945The USDouble-blind26 (11/15)13 (7/6)MSCPlaceboHuman stromal vascular fractiona: cells; b: cellsIntra-articular injectionWOMAC, adverse eventsa: ; b: 12 months
Lamo-Espinosa et al. [47]NCT02365142SpainNot known24 (7/17)26 (10/16)MSC+platelet-rich plasmaPlatelet-rich plasmaHuman bone marrow cellsIntra-articular injectionWOMAC, VAS, adverse events40-6233-7012 months
Bastos et al. [48]Multi-centerDouble-blind30 (15/15)17 (8/9)a: MSC+platelet rich plasma; b: MSCCorticosteroidHuman bone marrowNot knownIntra-articular injectionOther clinical indicatorsa: ; b: 12 months
Hong et al. [49]ChiCTR1800015125ChinaDouble-blind, but does not describe the implementationMSC in left: 8 (7/1); MSC in right 8 (6/2)MSC+sodium hyaluronateSodium hyaluronateHuman adipose tissueNot knownIntra-articular injectionWOMAC, VAS, adverse eventsMSC in left: ; MSC in right 12 months
Khalifeh Soltani et al. [50]IRCT2015101823298NIranDouble-blind10 (not known)10 (not known)MSCNormal salineHuman placenta cellsIntra-articular injectionVAS, adverse events35-7524 weeks
Zhang et al. [51]ChinaBlind for outcome assessment72 (56/16)36 (8/28)MSC+sodium hyaluronate or MSC onlySodium hyaluronateHuman adipose tissueNot knownIntra-articular injectionWOMAC, VASa: ; b: 3 years