ArticleWorld journal of stem cells2025
Does standalone/combined subchondral bone marrow-derived mesenchymal stem/stromal cell injection offer significantly better clinical benefit to intraarticular injection in knee osteoarthritis?
Article in World journal of stem cells, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundKnee osteoarthritis (OA) is a degenerative joint disease traditionally viewed through the lens of cartilage degradation. However, emerging evidence positions subchondral bone pathology - particularly bone marrow lesions (BMLs) - as a key contributor to pain, progression, and structural deterioration. Mesenchymal stem cell exhaustion within the osteoarthritic subchondral zone further impairs intrinsic repair mechanisms, reinforcing the rationale for biologic interventions.
aimTo evaluate the clinical efficacy of bone marrow aspirate concentrate (BMAC) therapy for knee OA, comparing subchondral
methodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five clinical studies were included - comprising three randomized controlled trials and two prospective cohorts - with pooled data from 298 knees. Data on functional outcomes, imaging findings, and progression to total knee arthroplasty (TKA) were extracted and qualitatively synthesized.
resultsSubchondral BMAC injections demonstrated superior improvements compared to intra-articular injection or placebo: Knee Injury and Osteoarthritis Outcome Score improved from 49.1 ± 1.9 to 61.2 ± 6.3 at 12 months (
conclusionTargeting subchondral bone with BMAC addresses underlying OA pathology and may offer disease-modifying potential beyond symptom relief. These findings support a paradigm shift toward whole-joint biologic therapy, positioning the subchondral matrix as a therapeutic epicenter in OA management.
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