Evaluation of intraarticular mesenchymal stem cell injection for pain associated with knee osteoarthritis

Objective: Osteoarthritis (OA) is a chronic degenerative joint disease that is common worldwide and causes a significant decrease in quality of life, especially in elderly patients. Recently, adipose-derived mesenchymal stem cells (AD-MSCs) have become important for regenerative medicine as a promising treatment for OA. The application of stem cells to damaged joints may provide pain relief and improve quality of life along with restoration of hyaline articular cartilage. The aim of our study was to evaluate the efficacy of AD-MSC injection on pain due to knee osteoarthritis. Materials and Methods: The efficacy of AD-MSC intra-articular knee injection for pain control in 59 patients who presented with knee pain between March 2019 and September 2022 at the Department of Algology, Akdeniz University Faculty of Medicine, was followed retrospectively and randomized. Patients over 18 years of age, with a radiologic diagnosis of osteoarthritis of the knee, persistent complaints despite primary conservative treatment, and acceptable hematologic and biochemistry profiles were included. Patients were divided into grade 2, grade 3 and grade 4 groups according to Kellgren-Lawrance classification. WOMAC and VAS scores were calculated at baseline and at 1, 3, 6, 12, and 24 months after injection. Data were analyzed using IBM SPSS Statistics 18 © Copyright SPSS Inc. 1989, 2010 software. A p value of less than 0.05 was required for statistical significance. Results: The change in WOMAC and VAS scores over time was statistically significant in all patients (p<0.001). In Grade 2 and Grade 3 patient groups, WOMAC and VAS scores were significantly lower at 24 months compared to baseline. In Grade 4 patients, the change in WOMAC score at month 3 was significant, while the measurements at month 24 were similar to the initial measurements. Conclusion: We believe that a single injection of AD-MSC is safe and effective for patients with Grade 2 and Grade 3 knee OA. The procedure does not seem to be beneficial for Grade 4 patients. We think that the reason for this may be the lack of necessary lifestyle modification especially for these patients. We believe that further studies evaluating Grade 4 patients over a longer period of time are needed to evaluate the efficacy of the injection.