Introduction: Osteoarthritis (OA) is a major cause of disability across the world, which its prevalence is relatively high in elder population. Current accepted therapies such as exercise, anti-inflammatory drugs and intra-articular inoculation of corticosteroids are aimed at controlling symptoms in the affected patients. Surgical options including arthroplasty, osteotomy and joint replacement are other choices of treatment, which are invasive and can be applied in case of failure of conventional therapies. In the last few decades, efforts to treat musculoskeletal diseases are being increasingly focused on regenerative cellular therapies.
Methods: Our search was limited to original papers in the English language from 2010 to 2018 using several databases including Pubmed, Scopus, Google Scholar, Cochran, and Scientific Information Database. A manual search of references provided in the included papers was also performed. Risk of bias was assessed using the Cochrane risk of bias tool. Descriptive synthesis was performed using the levels of evidence according to the Oxford Levels of Evidence.
Results: Of 536 electronically searched citations, 364 articles had the inclusion criteria. In last decade’s new approach for OA such as PRP therapy, mesenchymal cell and SVF therapy is more attention has been considered. Results of most clinical trials showed that new treatments have less side effects and more efficacy.
Conclusion: There is level-4 evidence for the use of stem cell injection of different types in the treatment of OA when evaluating pain and radiographic, arthroscopic and histological outcomes. It should be noted that all treatments were additional to surgery, HA or PRP injections. All studies were found to be at high risk of bias. Therefore, we do not recommend to use stem cell therapy for patients with KOA