Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials
Bibliographic record
Abstract
Abstract Purpose Implantation of mesenchymal stem cells (MSCs) is a potential non‐surgical option for cartilage repair. Currently, its clinical use largely focuses on focal cartilage defect repair and intra‐articular injections in knee osteoarthritis (OA). Most studies have looked at the efficacy of MSCs from autologous sources, which can be limited by inter‐patient variability of age, diseases, sites and methods of harvest. This systematic review aims to evaluate studies that focus on allogeneic MSCs implantation versus placebo in patients with knee OA to summarise the efficacy and safety of allogeneic MSCs in knee OA. Methods A systematic search following PRISMA guidelines was performed in PubMed, Scopus and EMBASE. Original studies investigating the outcomes of allogeneic MSC implantations in patients with knee OA were included. Data on clinical outcomes, such as subjective scores such as VAS and WOMAC, radiological outcomes, such as cartilage thickness, and histological outcomes, such as ICRSII score, were extracted. Results Seven studies were included in this review. There was 30.4 points improvement in Visual Analogue Scale scores and 40.0 points of improvement in Western Ontario and McMaster Universities Osteoarthritis Index scores at 12 months. Improved cartilage thickness and decreased poor cartilage quality as measured by T2 relaxation. Measurements at the lesion site were observed in three studies as assessed by postoperative magnetic resonance imaging and this was correlated clinically. One study also showed histological improvement with overall ICRSII scores significantly improving from 32.0 ± 21.6 at baseline to 55.9 ± 23.2 at 6 months ( p < 0.05). No major complications or tumorigenesis occurred. Conclusion Allogeneic MSC implantation in patients with knee osteoarthritis provides sustained clinical improvement and satisfactory cartilage restoration, up to 12 months follow‐up. These results are supported by both imaging and histological studies. The safety profile of allogeneic MSCs is excellent, with minimal adverse events mainly limited to local reaction to injection and no long‐term adverse effects. Level of Evidence Level II.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.035 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.013 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".