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World J Orthop. Sep 18, 2017; 8(9): 674-680
Published online Sep 18, 2017. doi: 10.5312/wjo.v8.i9.674
Mesenchymal stem cells for cartilage regeneration in osteoarthritis
Baldur Kristjánsson, Sittisak Honsawek
Baldur Kristjánsson, Sittisak Honsawek, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
Sittisak Honsawek, Department of Orthopaedics, Vinai Parkpian Orthopaedic Research Center, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
Author contributions: Kristjánsson B performed the majority of the writing, prepared the figures; Honsawek S provided the input in writing the paper, prepared the figures, revised and finalized the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sittisak Honsawek, MD, PhD, Department of Orthopaedics, Vinai Parkpian Orthopaedic Research Center, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Rama IV Road, Patumwan, Bangkok 10330, Thailand. sittisak.h@chula.ac.th
Telephone: +66-2-2564482 Fax: +66-2-2564482
Received: February 27, 2017
Peer-review started: February 28, 2017
First decision: May 9, 2017
Revised: June 1, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: September 18, 2017
Processing time: 197 Days and 5.7 Hours
Abstract

Osteoarthritis (OA) is a slowly progressive disease where cartilage of the synovial joint degenerates. It is most common in the elderly where patients experience pain and reduce physical activity. In combination with lack of conventional treatment, patients are often left with no other choices than arthroplasty. Over the last years, multipotent stromal cells have been used in efforts to treat OA. Mesenchymal stem/progenitor cells (MSCs) are stromal cells that can differentiate into bone, fat, and cartilage cells. They reside within bone marrow and fat. MSCs can also be found in synovial joints where they affect the progression of OA. They can be isolated and proliferated in an incubator before being applied in clinical trials. When it comes to treatment, emphasis has hitherto been on autologous MSCs, but allogenic cells from healthy donors are emerging as another source of the cells. The first adaptations of MSCs revolved in the use of cell-rich matrix, delivered as invasive surgical procedure, which resulted in production of hyaline cartilage and fibrocartilage. However, the demand for less invasive delivery of cells has prompted the use of direct intra-articular injections, wherein a large amount of suspended cells are implanted in the cartilage defect.

Keywords: Intra-articular injection; Mesenchymal stem cells; Osteoarthritis; Regeneration; Cartilage

Core tip: There are several published reviews of the role of multipotent stromal cells in osteoarthritis (OA) of the knee. However, there is also need for additional current therapeutic options and clinical trials of multipotent stromal cells for OA. We review additional therapeutic potentials of mesenchymal stem cells in knee OA using either autogenous or allogenic cells. Direct intra-articular injections of cells in suspension become a delivery method, being both relatively simple and cost effective compared to major surgical procedures. The amount of cells injected is a critical factor; higher numbers of cells resulting in greater pain reduction and increased cartilage volume.