Date of Graduation

Summer 8-12-2017

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Osteoarthritis is a prevalent disease process that is characterized by degeneration of cartilage in weight-bearing joints. This loss of cartilage results in high levels of pain, joint stiffness, loss of range of motion and function, and psychological distress. Current osteoarthritis treatment focuses on reduction of pain and swelling and improvement of quality of life for the patients. Recently, mesenchymal stem cells have been of interest in this disease process due to their self-renewal, multipotent differentiation, and immunomodulatory properties. Can mesenchymal stem cell injections or implantation in patients with osteoarthritis of the knee improve level of function and magnetic resonance imaging results?

Methods: An exhaustive search of available medical literature using MEDLINE-Ovid, CINAHL, and Web of Science was conducted using the key words “mesenchymal stem cell transplantation” and “osteoarthritis, knee”. The results were screened with eligibility criteria. The remaining articles were evaluated and assessed for quality using GRADE.

Results: Two studies met inclusion and exclusion criteria and were included in this systematic review. One prospective cohort study looked at 20 patients with osteoarthritis of the knee and performed mesenchymal stem cell implantation. The results showed overall improvement in level of function and magnetic resonance imaging (MRI) results. One therapeutic case series looked at 25 patients with osteoarthritis of the knee and performed mesenchymal stem cell injections. Although seven patients were lost to follow-up, results showed overall improvement in pain, level of function, and MRI results.

Conclusion: Mesenchymal stem cell implantation or injections have been found to improve level of function and MRI results at two years after the initial procedure. However, there is not sufficient quality evidence to show that this treatment option should be implemented into standard of care for patients with osteoarthritis. While study results are promising, further research with larger study sizes, variable techniques, and longer follow-up are needed to validate this treatment and determine at what point in the osteoarthritis disease process it should be utilized.

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