Stem cell therapy for knee osteoarthritis: a narrative review of a rapidly evolving treatment with implications for physical therapy management

Abstract

Background: Stem cell therapy has emerged as a new, exciting treatment for repair of articular cartilage in osteoarthritis (OA), which currently has no cure. Regenerative cell therapies can potentially offer alternatives to total joint replacement for patients with OA. A variety of cell-based therapies have been developed involving the use of autologous and allogeneic mesenchymal stem cells (MSCs). To date, these stem cell therapies have been shown to be safe and efficacious, but information on the long-term clinical outcomes for joint function is lacking. Also lacking is information regarding post-treatment rehabilitation strategies and their effects.Objectives: The purpose of this narrative review was to evaluate the current literature in relation to stem cell therapy for knee OA and to highlight the importance of physical therapists establishing and researching suitable care management and rehabilitation procedures for patients receiving stem cell therapy.Major findings: The results of this literature review show that MSCs have been safe and effective at reducing pain and improving joint functionality and cartilage quality. The review also found that both autologous and allogeneic stem cells were able to produce similar clinical improvements in pain scores and cartilage repair and restoration. There is a lack of research evaluating the influence of rehabilitation on cartilage repair.Conclusions: Current research shows that significant improvements in joint pain and function continue for approximately 2-year post-stem cell procedure. There is currently a lack of research into rehabilitation protocols which could potentially improve joint function further.