The Efficacy of Bone Marrow Stem Cell Therapy in Hip Osteoarthritis: A Scoping Review

Olivia F. Perez, Christopher Warburton, Marc C. Philippon, Marc J. Philippon, Thomas M. Best
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Abstract

Hip osteoarthritis (HOA) is a prevalent degenerative joint disease with various treatment approaches. Biological agents, such as bone-marrow derived stem cells (BM-MSC) therapy, have recently been proposed as a treatment option in the management of HOA. We sought to further analyze the use of BM-MSC therapy by investigating the following questions. What is the standard preparation and practice? Does a dose response exist between stem cell therapy and clinical outcome? Does BM-MSC therapy alone produce effective clinical outcomes? We conducted a scoping review using the Methodological Expectations of Cochrane Intervention Reviews Manual and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for scoping reviews. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, Scopus, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, and Web of Science Core Collection was performed in June 2023 of studies using exclusively BM-MSC injections for the treatment of HOA. Study characteristic, injection preparation and dosage, clinical outcome measures, and adverse effect data were extracted and interpreted by 3 reviewers. Seven studies with a total of 72 patients met the inclusion criteria. Clinical outcome following intra-articular injection of BM-MSCs was measured using the numerical pain scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the visual analogue scale, and other scores, all of which showed reduction in pain and increase in functional ability across studies. This scoping review found that the efficacy of BM-MSC therapy alone in the treatment of HOA appeared beneficial, improving clinical outcomes in each study. All 7 studies used “low-dose” injections with variable follow-up times; thus, a clear dose–response relationship cannot be drawn. Future studies using high doses and analyzing long-term effects of BM-MSC injections in HOA are needed.
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骨髓干细胞疗法对髋关节骨性关节炎的疗效:范围界定综述
髋关节骨关节炎(HOA)是一种常见的退行性关节疾病,治疗方法多种多样。生物制剂,如骨髓干细胞(BM-MSC)疗法,最近被提议作为治疗髋关节炎的一种治疗方法。我们试图通过研究以下问题来进一步分析骨髓干细胞疗法的使用情况。标准的准备和实践是什么?干细胞疗法与临床结果之间是否存在剂量反应?单用干细胞间充质干细胞疗法能否产生有效的临床疗效?我们采用《Cochrane干预综述方法学期望手册》(Methodological Expectations of Cochrane Intervention Reviews Manual)和《系统综述和元分析首选报告项目》(Preferred Reporting Items for Systematic Review and Meta-Analysis,PRISMA)指南进行了范围界定综述。2023年6月,我们在PubMed、Embase、Cochrane CENTRAL、Scopus、SPORTDiscus、《护理与专职医疗文献累积索引》和Web of Science Core Collection中全面检索了完全使用BM-间充质干细胞注射治疗HOA的研究。3名审稿人对研究特点、注射制剂和剂量、临床结果测量和不良反应数据进行了提取和解释。7项研究共72名患者符合纳入标准。采用数字疼痛量表、西安大略和麦克马斯特大学骨关节炎指数、视觉模拟量表和其他评分方法测量了关节内注射 BM-MSCs 后的临床疗效。这项范围界定综述发现,单用BM-间充质干细胞疗法治疗HOA似乎是有益的,每项研究的临床结果都有所改善。所有 7 项研究均采用 "低剂量 "注射,随访时间各不相同,因此无法得出明确的剂量-反应关系。未来还需要进行使用高剂量的研究,并分析注射干细胞治疗HOA的长期效果。
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