What is the efficacy of mesenchymal stem cell therapy for the treatment of osteoarthritis (OA)?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In clinical trials, placement of MSCs into the knee joint has proved an effective treatment for osteoarthritis, with no significant increases in adverse events. [71, 72, 11, 150, 149] However, no MSC therapies have yet been cleared by the FDA for human clinical application to musculoskeletal diseases. [101]

A meta-analysis comparing the conditions of patients with knee osteoarthritis before and after treatment with MSCs demonstrated continual efficacy for at least 24 months, with greater pooled effect size (pain and functional changes) at 12 and 24 months than summed effect sizes at 3 months. However, a dose-responsiveness association was not demonstrated in the MSC numbers. Notably, MSC therapy appeared more beneficial in patients with early osteoarthritis than in those with advanced disease. [71]

Two systematic reviews have questioned the quality of the studies of stem cell therapy for knee osteoarthritis, citing high risk of bias, low quality of evidence, only modest improvement reported, and possible placebo effect. [73, 74]  Additional studies are needed with standardization of methdology, efficacy reporting, and safety. Nevertheless, a survey identified hundreds of clinics in the United States that offer stem cell therapy for knee arthritis, at prices ranging from $1150 to $12,000 for a unilateral injection. In many cases these injections would consist of centrifuged blood or bone marrow aspirate rather than cultivated stem cells. [151]   


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