Article
The clinical outcomes of intra-articular injection of human umbilical cord blood-derived mesenchymal stem cells versus bone marrow aspirate concentrate in cartilage regeneration: A systemic review
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Authors
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Jian Xing
- Trauma and Orthopaedics, Xi'an Honghui Hospital, Xi'an, China
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Pengfei Wang
- Trauma and Orthopaedics, Xi'an Honghui Hospital, Xi'an, China
| Published: | October 21, 2024 |
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Outline
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Purpose: This systemic review focus on which sources of MSCs has the better beneficial for cartilage repair comparing between hUCB-MSCs with bone marrow aspirate concentrate (BMAC) in patients treating via HTO plus MSCs augmentation.
Methods: Included literatures were searched from Pubmed, Scopus, Embase, Cochrane and Web of Science that presented in English language and compared the effect between hUCB-MSCs amplification with BMAC transplantation in articular cartilage lesion of human knee with follow-up at least 1 years after surgery. The risk of bias of included retrospective studies were assessed via Coleman Methodology Score. The clinical prognosis was assessed by total clinical scores, pain, function and degree of cartilage repair.
Results: The risk of bias of included retrospective cohort studies were evaluated as fair level. Formal meta-analysis was precluded in outcomes as the low-evidences and retrospective pooled studies cause high heterogeneous reporting. In average 1 year after surgery, two included studies reported hUCB-MSCs group (Lee: 71.2% and 81.3%; Yang: 77.3%) presented higher ratio of normal and nearly normal cartilage repair assessed by ICRS grading under second-arthroscopy than BMAC group (Lee: 45% and 40.5%; Yang: 56.8%). Ryu et al reported that there is no significant different between each group in ICRS grading system after 1-year post-operation (P = 0.655). The total clinical outcome, pain and function were significant improved at last follow-up in both BMAC group and hUCB-MSCs group, while there is no significant divergence between each group.
Conclusion: This systemic review presented comparing with BMAC injection, intra-articular of hUCB-MSCs can induce significant better repair tissue at 1 year after surgery assessing by ICRS. Although there is only short-term following-up evidence and lack of histochemical evidences, our systemic review willing to recommend hUCB-MSC as the source of pluripotent stem cells for treating ICRS III cartilage lesion. Level of Evidence: Level III.
