Mesenchymal or Maintenance Stem Cell & Understanding Their Role in Osteoarthritis of the Knee Joint: A Review Article

Document Type: CURRENT CONCEPTS REVIEW

Authors

1 Department of Orthopaedics, Saudi German Hospital, Dubai, UAE

2 GEMS Modern Academy, Dubai UAE

10.22038/abjs.2020.42536.2155

Abstract

Mesenchymal Stem Cell (MSC) therapy in osteoarthritis has been hailed as a promising treatment for osteoarthritis due
to their unlimited potential of healing and regeneration. Existing literature regarding their proper name, optimal sources,
mechanisms of action, dosage, and route of administration, efficacy, and safety is debatable. This index review article
has tried to connect these puzzling pieces of available information and brought clarity on some of these crucial issues.
The author believes that Maintenance Stem Cells (MSC) may be a more suitable term than mesenchymal stem cell or
medicinal signaling cells as their origin might not be limited to mesodermal tissue. Also, they have been shown capable
of self-renewal, differentiation, and maintaining a cascade of healing & possibly regeneration at the implanted site. Only
a small percentage of implanted MSC survive and rest undergo apoptosis after releasing growth factors, cytokines, and
extracellular vesicles. These surviving MSC become active due to conformational changes induced by anti-environment
stimuli and undergo limited self-renewal, proliferation, and differentiation, but only a few of them might incorporate into the
host tissues. These cells generate & maintain a momentum of series of regenerative activities to improve the function of
joint, stabilize or possibly enhance the cartilage quality. More randomized studies with long term follow-up are required to
bring clarity on their ideal source, expansion, culture technique, optimum dosage, and route of administration and longterm
safety issues.
Level of evidence: V

Keywords