Current clinical evidence for the use of mesenchymal stem cells in articular cartilage repair

ABSTRACT

Introduction: Articular cartilage is renowned for its poor intrinsic capacity for repair. Current treatments for osteoarthritis are limited in their ability to reliably restore the native articular cartilage structure and function. Mesenchymal stem cells (MSCs) present an attractive treatment option for articular cartilage repair, with a recent expansion of clinical trials investigating their use in patients.

Areas covered: This paper provides a current overview of the clinical evidence on the use of MSCs in articular cartilage repair.

Expert opinion: The article demonstrates robust clinical evidence that MSCs have significant potential for the regeneration of hyaline articular cartilage in patients. The majority of clinical trials to date have yielded significantly positive results with minimal adverse effects. However the clinical research is still in its infancy. The optimum MSC source, cell concentrations, implantation technique, scaffold, growth factors and rehabilitation protocol for clinical use are yet to be identified. A larger number of randomised control trials are required to objectively compare the clinical efficacy and long-term safety of the various techniques. As the clinical research continues to evolve and address these challenges, it is likely that MSCs may become integrated into routine clinical practice in the near future.

KEYWORDS:

• Mesenchymal stem cells
• cartilage
• osteoarthritis
• articular cartilage defects
• regeneration

Article highlights

• There has been a recent expansion of clinical trials investigating MSCs for the regeneration of hyaline articular cartilage in patients.

• The majority of clinical trials to date have demonstrated significant improvements in clinical, histological and radiological grading scores for patients undergoing MSC therapies, with minimal adverse effects.

• However, the clinical research is still in its infancy and a number of important challenges need to be addressed prior to their widespread clinical use.

• A larger number of randomized control trials with long-term follow up are required to establish the optimum MSC source, cell concentrations, implantation technique, scaffold, growth factors and rehabilitation protocol for clinical use.

• As the clinical research continues to evolve and address these challenges, it is likely that MSCs may become integrated into routine clinical practice in the near future.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.