Comparative Efficacy and Safety of Mesenchymal Stem Cell Therapy and Hyaluronic Acidin Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Abstract

Knee osteoarthritis (OA) is the most common d disease of degenerative nature leading to the pain, reduced mobility, and diminished quality of life. Currently, treatment options are conservative approaches and advanced therapies like mesenchymal stem cell (MSC) therapy and hyaluronic acid (HA) in the injectable form Current systematic review assesses the effectiveness, safety, and comparative outcomes of MSC therapy versus HA in managing knee OA.

Methods: This systematic review and meta-analysis was conducted following PRISMA guidelines (PROSPERO registration: CRD42023473958). Literature searches across multiple databases identified randomized clinical trials (RCTs) comparing MSC therapy with HA in knee OA patients. Risk of bias was assessed using RoB 2.0, and meta-canalyses employed a random-effects model to aggregate data from eligible studies.

Results: Four RCTs involving 120 patients were encompassed. Studies showed that MSC therapy, especially at higher doses, improved pain, function (WOMAC and VAS scores), and cartilage quality compared to HA. MSC- treated groups exhibited sustained benefits, including improved joint mobility and reduced inflammation, over long- term follow-ups. Meta-analysis indicated significant heterogeneity (I2 > 80%), limiting definitive conclusions on pooled results. No severe adverse events were considered for MSC therapy, underscoring its safety profile. Risk of bias ranged from low to intermediate across studies.

Conclusion: MSC therapy shows promise in improving clinical outcomes for knee OA compared to HA. However, high heterogeneity in study outcomes and intermediate risk of bias warrant caution. Further large-scale, well- designed RCTs are necessary to verify these findings and optimize therapy protocols.