Comparative effectiveness of adipose-derived mesenchymal stromal cells in the management of knee osteoarthritis: A meta-analysis

Table 2 Stem cell transplantation protocol of the included studies

Ref.	MSC type	MSC source	MSC preparation	MSC count (107 cells)	Treatment group intervention	Control group intervention	Outcome measures
Vega et al[23], 2015	BM	Allo	CE-BMMSC	4	sIA injection of MSC	sIA Injection of 60 mg HA	VAS, WOMAC
Vangsness et al[24], 2014	BM	Allo	CE-BMMSC	5/15	sIA injection of MSC + 20 mg HA	sIA Injection of 20 mg HA	VAS, Lysholm Score
Garay-Mendoza et al[25], 2018	BM	Auto	BMC	NA	600 μg/d G-CSF for 3 consecutive days before the procedure + sIA injection of MSC	Oral acetaminophen, 500 mg every 8 h for 6 mo	VAS, WOMAC
Kuah et al[26], 2018	AD	Allo	CE-ADMSC	0.39-0.67	sIA injection of MSC	Placebo sIA injection of cell culture media and cryopreservative	VAS, WOMAC, MRI assessment
Estrada et al[22], 2020	AD	Auto	BMC	NA	sIA injection of BM concentrate	sIA injection of PRP	IKDC, Lysholm Score, KOOS
Estrada et al[22], 2020	BM	Auto	SVF	NA	sIA injection of lipoaspirate	sIA injection of PRP
Freitag et al[27], 2019	AD	Auto	CE-ADMSC	10	sIA injection of MSC ± 2nd injection at 6 mo	Conservative management	VAS, WOMAC, KOOS, MRI assessment
Ruane et al[41], 2021	BM	Auto	BMC	NA	sIA injection of BM concentrate + PRP	Gel-One® Cross-Linked hyaluronate injection	VAS, KOOS
Lamo-Espinosa et al[28], 2016	BM	Auto	CE-BMMSC	1	sIA injection of MSC + 60 mg HA	sIA injection of 60 mg HA	VAS, WOMAC, MRI assessment
Garza et al[29], 2020	AD	Auto	SVF	NA	sIA injection of MSC	Placebo injection without cells	WOMAC, MRI assessment
Wong et al[30], 2013	BM	Auto	CE-BMMSC	1.46	HTO + microfracture + sIA injection of MSC + 20 mg HA	HTO + microfracture + sIA injection of 20 mg HA	Tegner Score, Lysholm Score
Lu et al[31], 2019	AD	Auto	CE-ADMSC	5	2 IA injection of MSC at 0, 3 wk and sham injection at 1, 2 wk	4 IA injection of 25 mg HA at 0, 1, 2, 3 wk	VAS, WOMAC
Lv et al[42], 2015	BM	Auto	CE-BMMSC	3.82	3 × monthly IA injection of MSC + 20 mg HA	sIA injection of 20 mg HA	Tegner Score, Lysholm Score
Emadedin et al[32], 2018	BM	Auto	CE-BMMSC	4	sIA injection of MSC	Placebo sIA injection of normal saline	VAS, WOMAC
Gupta et al[33], 2016	BM	Allo	CE-BMMSC	2.5-15	sIA injection of MSC + 20 mg HA	Placebo sIA injection of 20 mg HA	VAS, WOMAC, MRI assessment
Bastos et al[34], 2020	BM	Auto	CE-BMMSC	4	sIA injection of MSC in 10 mL of PRP	sIA injection of 4 mg dexamethasone	KOOS, MRI assessment
Wakitani et al[35], 2002	BM	Auto	CE-BMMSC	1	HTO + microfracture + sIA injection of MSC	HTO + microfracture + placebo injection	MRI assessment, HSS knee rating scale
Tran et al[36], 2019	AD	Auto	SVF	NA	Arthroscopic micro fracture + sIA injection of MSC	Arthroscopic micro fracture	WOMAC, MRI assessment
Lee et al[37], 2019	AD	Auto	CE-ADMSC	10	sIA injection of MSC	Placebo injection with normal saline	WOMAC, MRI assessment
Koh et al[38], 2012	AD	Auto	SVF	0.189	Arthroscopic debridement + sIA injection of MSC + PRP	Arthroscopic debridement + PRP	VAS, Tegner Score, Lysholm Score
Koh et al[39], 2014	AD	Auto	CE-ADMSC	0.411	HTO + sIA injection of MSC + PRP	HTO + PRP	VAS, Lysholm Score
Hong et al[40], 2019	AD	Auto	SVF	0.745	sIA injection of MSC	sIA injection of 40 mg HA	VAS, WOMAC, MRI assessment

AD: Adipose derived; Allo: Allogenic; Auto: Autologous; BM: Bone marrow; BMC: Bone marrow concentrate; CE-ADMSC: Culture expanded adipose derived mesenchymal stem cell; CE-BMMSC: Culture expanded bone marrow mesenchymal stem cell; HA: Hyaluronic acid; HSS: Hospital for special surgeries; HTO: High tibial osteotomy; IA: Intra-articular; IKDC: International Knee Documentation Committee; KOOS: Knee Osteoarthritis Outcome Score; PRP: Platelet rich plasma; MRI: Magnetic resonance imaging; MSC: Mesenchymal stem cell; sIA: Single intra-articular; SVF: Stromal vascular fraction; VAS: Visual analog score; WOMAC: Western Ontario Mc-Master Universities Osteoarthritis index.