Efficacy based on dose-response and safety of bone marrow-derived mesenchymal stem cells for the treatment of osteoarthritis: a systematic review and meta-analysis

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 In recent years, the use of mesenchymal stem cells (MSCs), especially those derived from bone marrow and embryonic sources, has been considered as an emerging therapeutic approach for repairing joint tissue and reducing osteoarthritis symptoms. This systematic review and meta-analysis evaluated bone marrow-derived mesenchymal stem cells (BM-MSCs) efficacy, safety, and optimal dosing for osteoarthritis treatment. Methods Thirteen randomized trials of the 1427 articles identified (11 meta-analyzed; n = 1150 patients) were identified via PubMed, Scopus, Embase, and other databases (search updated to May 2025). The primary outcomes were the optimal dose of BM-MSCs in improving pain intensity (VAS), WOMAC scores (pain, stiffness, function, total score), and their safety, analyzed using RevMan 5.4. Cochrane risk-of-bias assessment guided quality appraisal. Results BM-MSCs showed no significant pain reduction (VAS) or functional improvement (WOMAC) at 1-3 months' post-injection. Significant improvements emerged at 6 months, peaking at 12 months: VAS decreased by WMD - 2.31 (95% CI - 3.83 to - 0.80; P = 0.003), and WOMAC total score reduced by WMD - 10.14 (95% CI - 18.26 to - 2.02; P = 0.01). Subgroup analyses indicated optimal doses of ≤ 25 × 10⁶ cells for VAS improvement and ≤ 25 × 10⁶ or 25-50 × 10⁶ cells for WOMAC total score at 12 months. Safety profiles were favorabl

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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