Total Knee Arthroplasty versus Mesenchymal Stem Cell Therapy for Moderate Knee Osteoarthritis: An Umbrella Analysis of Clinical Outcomes, Quality of Life, and Safety

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dc.contributor.authorAngthong, Chayanin
dc.contributor.authorVichayabhai, Tyler
dc.contributor.authorTatiya-Apitham, Phurin
dc.contributor.authorAngthong, Wirana
dc.date.accessioned2026-08-06T10:55:01Z
dc.date.available2026-08-06T10:55:01Z
dc.date.issued2026-03-31
dc.description.abstract<p>Background. Moderate knee osteoarthritis (Kellgren-Lawrence [KL] Grade 2-3) represents a critical therapeutic crossroads where patients must choose between regenerative strategies and surgical replacement. This umbrella analysis synthesizes current evidence regarding the clinical efficacy, quality of life, and safety profiles of mesenchymal stem cell (MSC) therapy relative to total knee arthroplasty (TKA).<br />Material and methods. Following PRISMA 2020 guidelines, we systematically searched seven databases (2016-2026). Screening of 1,211 records identified 242 unique papers for full-text assessment. Eligible studies included systematic reviews, meta-analyses, and large prospective cohorts (>50 participants) evaluating intra-articular MSCs or TKA in KL Grade 2-3 populations with ≥12-month follow-up.<br />Results. Our analysis reveals a profound evidence gap: zero studies directly compared MSC therapy to TKA in this population. Data from 30 high-quality studies demonstrate that MSC therapy significantly outperforms placebo and conservative management, yielding VAS pain reductions of 20-40 points and WOMAC functional improvements of 15-35 points at 12-24 months. Adipose-derived MSCs showed superior analgesia, while umbilical cord-derived MSCs optimized functional recovery. MSC therapy significantly reduced the hazard of TKA conversion (HR 0.52, p<0.001). At 36-60 months, conversion rates were 12.4% for MSCs versus 22.7% for control groups. Safety profiles remained favorable with serious adverse event rates <5%.&nbsp;<br />Conclusions. 1. While MSC therapy is a demonstrably effective bridge for delaying TKA in selected KL Grade 2-3 patients, its comparative effectiveness and long-term durability relative to arthroplasty remain uncharacterized. 2. High-quality randomized controlled trials directly benchmarking MSCs against TKA are urgently required to resolve this clinical impasse and inform treatment algorithms.</p>.
dc.identifier.citationOrtopedia Traumatologia Rehabilitacja, 28(1), 15-22, 2026
dc.identifier.doi10.5604/01.3001.0055.7770
dc.identifier.issn20844336
dc.identifier.other2-s2.0-105042015514
dc.identifier.urihttps://dspace.kmitl.ac.th/handle/123456789/17970
dc.sourceOrtopedia Traumatologia Rehabilitacja
dc.subjectKellgren-Lawrence grade
dc.subjectKey words: knee osteoarthritis
dc.subjectmesenchymal stem cells
dc.subjectPRISMA 2020
dc.subjectquality of life
dc.subjectregenerative medicine
dc.subjecttotal knee arthroplasty
dc.titleTotal Knee Arthroplasty versus Mesenchymal Stem Cell Therapy for Moderate Knee Osteoarthritis: An Umbrella Analysis of Clinical Outcomes, Quality of Life, and Safety
dc.typeArticle

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