Comparative efficacy of different doses of mesenchymal stem cells derived from different tissue sources for knee osteoarthritis: a systematic review and network meta-analysis of randomized controlled trials.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Introduction Knee osteoarthritis (KOA) remains a leading cause of disability, and mesenchymal stem cells (MSCs) show potential for KOA treatment. However, existing studies demonstrate conflicting results on the optimal dose and tissue source of MSCs for KOA treatment. This gap limits evidence-based treatment decisions. Materials & methods A network meta-analysis (NMA) was conducted to evaluate the efficacy and safety of MSCs at different doses and from tissue sources in treating KOA. Randomized controlled trials (RCTs) were searched up to November 12, 2025. MSC doses were categorized into low ((0 6 ), moderate ((20 ≤ cells 6 ), and high (cells ≥ 50 ×10 6 ). Efficacy was assessed using Visual Analog Scale (VAS) scores, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, and adverse events (AEs) at 3, 6, and 12 months. Results A total of 11 RCTs were included. Except for moderate-dose bone-derived MSCs (M_BMSCS), all treatment groups significantly improved VAS scores at 3, 6, and 12 months. High-dose adipose-derived MSCs (H_ADSCS) showed superior efficacy at 3 months, while moderate-dose adipose-derived MSCs (M_ADSCS) was most effective at 6 and 12 months. For WOMAC scores, significant improvements were seen at 12 months for high-dose, moderate-dose, and low-dose adipose-derived MSCs (ADSCS), as well as low-dose bone-derived MSCs (L_BMSCS), with M_ADSCS show

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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