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

• Author(s): Bastos, Ricardo ; Mathias, Marcelo ; Andrade, Renato ; Amaral, Ronaldo J. F. C. ; Schott, Vinicius ; Balduino, Alex ; Bastos, Raquel ; Oliveira, Joaquim M. ; Reis, R. L. ; Rodeo, Scott ; Espregueira-Mendes, João
• Date: 2020
• Persistent ID: https://hdl.handle.net/1822/62147
• Origin: RepositóriUM - Universidade do Minho
• Subject(s): Osteoarthritis; Mesenchymal stem cells; Intra-articular injection; Platelet-rich plasma
• Document Type: Journal article
• Language: English
• Contributor(s): Universidade do Minho

Description

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 (nâ =â 16); autologous bone marrow-derived culture-expanded MSCsâ +â PRP (nâ =â 14); and corticosteroid (nâ =â 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 (pâ <â 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (pâ =â 0.003). The MSCs and MSCsâ +â 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 (pâ <â 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.