Knee pain is a common complaint mainly occurs due to an injury, such as a ruptured ligament or torn cartilage. Some medical conditions such as arthritis, gout and infections can also results into knee pain. Major symptoms of knee injury involve pain, swelling and stiffness. There are two main type of arthritis osteoarthritis (OA) and rheumatoid arthritis (RA). Osteoarthritis involves degradation of cartilage which covers the ends of bones where they form a joint. Rheumatoid arthritis (RA) is an autoimmune and inflammatory form of arthritis that initially targets the lining of joints called as synovium which encloses and protects the joint. Current medical treatment shows little influence on the progressive degeneration of articular cartilage. Consequently, developing effective and financially feasible disease-modifying therapies is a critical medical priority. Mesenchymal stem cells (MSCs) have appeared as potential cellular therapy having a great potential for articular cartilage repair in patients with knee OA.
Several clinical trials that investigating the ability and effectiveness of MSC treatments in patients with knee OA have recently begun developing,and outcomes of these studies are continuously reported. A number of meta-analyses review the effects of MSC treatment in patients with knee OA and contribute to the establishment of effective cell-based therapies for degenerative cartilage disease. Mesenchymal stem cells (MSCs) are categorised as self-renewing, postnatal, multipotent stem cells that have an ability to differentiate into all tissue of skeletal system and connective tissues such as fat, bone, muscle and cartilage. MSCs secrete huge range of anti-inflammatory bioactive molecules, cytokines and growth factors. Basically, Multipotent MSCs are initially derived from the embryonic tissue-mesenchyme which is originate from the mesoderm and can be isolated from different sources comprising bone marrow, trabecular bone, periosteum, adipose tissue, skeletal tissues, synovium and deciduous teeth . In humans, numbers of clinical trials have been initiated to evaluate the potential of MSC therapy for treatment of OA. A case report has proven meniscus and cartilage repair, identified through MRI. Additionally, improved range of motion and reduced visual analogue scale score also reported after injection of autologous bone marrow derived mesenchymal stem cells (BM-MSC) into the knee of an OA patient. In 2011, Centeno later issued a case series of 339 patients, demonstrating that patients who required total knee replacement (69 % of the patient cohort) out of that only 6.9 % still needed replacement surgery after MSC therapy. 60 percent of patients reported >50 percent pain relief and 40 percent reported >75 percent pain relief at 11 months. Recently, phase I and II trials utilizing expanded adipose tissue derived MSCs in the treatment of OA have revealed MRI proof of cartilage regrowth. Number of clinical trials reported the potential ability of MSCs therapy in alleviating the disease burden of joint diseases via their ability of tissue repair and the property of immune regulation. Importantly, more clinical trials are needed to evaluate effective application of mesenchymal stem cell therapy in arthritis management.
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