Journal
EXPERT OPINION ON BIOLOGICAL THERAPY
Volume 21, Issue 8, Pages 1035-1047Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14712598.2021.1872538
Keywords
Cell-based therapy; mesenchymal stem cell; anterior cruciate ligament injury; patellar tendinopathy; meniscal tear
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The evidence for the effectiveness of cell-based therapies in soft-tissue sports injuries of the knee is currently lacking high-quality support. There is a need for more standardized protocols and reporting, as well as further basic scientific research and large clinical trials to better understand the potential of MSCs and improve their application in clinical settings.
Introduction: An ever-increasing number of clinics are offering purportedly 'regenerative' stem-cell treatments, although cell-based therapies may not primarily act as stem cells and have shown the ability to regenerate end-target tissues in some clinical studies only. We aim to systematically review the evidence for their use in soft-tissue sports injuries of the knee. Areas covered: A search for articles pertaining to the use of preparations of, or containing, mesenchymal stem cells (MSCs) in human subjects in sports knee injuries yielded 14 relevant results for inclusion after screening: 7 used cultured MSCs, 5 bone marrow concentrate (BMC), and the remaining 2 evaluated stromal vascular fraction (SVF) and tenocyte-like-cells. Most studies were level 3 or lower (n = 9). Expert opinion: There is insufficient high-quality evidence for the use of cell-based therapies that demonstrates either ligamentous or tendinous healing, meniscal volume restoration, or post-traumatic osteoarthritis amelioration/regression. Methods of cell harvesting, preparation, and application are highly heterogenous. Efforts should be directed toward standardization of protocols and their reporting, starting with more basic scientific investigations of MSCs and their niche, as well as rigorous, large clinical RCTs adhering to the reporting principles set out by recent expert consensus.
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