ਸਟੈਮ ਸੈੱਲ ਅਤੇ ਰੀਜਨਰੇਟਿਵ ਇੰਜੈਕਸ਼ਨ ਜਾਣਕਾਰੀ

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

• There is insufficient evidence to recommend stem cell injections in clinical practice at this time [1].
• Stem cell injections should continue to be studied in rigorous trials [1].
• Mesenchymal stem cell (MSC) injections represent a growing area of research in traumatology and orthopaedics [2].
• More knowledge regarding the biological properties of MSCs and endothelial progenitor cells (EPCs) is required before using these cells as a routinely applied therapy in the clinical setting [3].
• The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis (PTOA) [4].
• The best effects of stem cell treatment for PTOA are observed on days 7 and 14 after anterior cruciate ligament transection (ACLT) [4].
• Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration [5].
• Exosomes overcome limitations such as donor-site morbidity and tumorigenesis associated with mesenchymal stem cell therapies [5].
• A better understanding of exosome mechanisms and standardized isolation methods is required before clinical application [5].
• Mesenchymal stem cells (MSCs) have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [6].
• The application of MSCs should be guided by the pathophysiology of the target disease [6].
• The application of MSCs should follow regulatory frameworks to ensure safe and effective use [6].
• Interventions employing platelet-rich plasma (PRP), MSCs, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [7].
• The outcome of MSC tissue engineering approaches is influenced by the methodologies and materials used during the cycle from the isolation of MSCs to their re-implantation [10].
• Cells with the characteristics of stromal stem cells were isolated from irrigation fluid, which is normally discarded [22].

How It Works

• Exosomes overcome limitations of mesenchymal stem cell therapies such as donor-site morbidity and tumorigenesis [5].
• Repeated intra-articular injections of PRP and adipose-derived stem cells (ADSCs) alleviated inflammation and pain in rats with surgically induced osteoarthritis [8].
• Repeated intra-articular injections of PRP and ADSCs promoted tissue repair in rats with surgically induced osteoarthritis [8].
• Repeated intra-articular injections of PRP and ADSCs modulated immune responses in rats with surgically induced osteoarthritis [8].
• Mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources are used in the treatment of osteoarthritis [9].
• Endogenous MSCs can be pharmacologically mobilized into peripheral blood [11].
• Endogenous MSCs can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [11].
• Osteogenically pre-differentiated adipose-derived stem cells (ASCs) demonstrated enhanced bone regenerative capacity compared with undifferentiated ASCs in experimental nonunion fractures [12].
• Local delivery of MSC-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [13].
• Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [17].
• Local application of bone marrow aspirate concentrate (BMAC) without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [18].

What the Evidence Shows

• Stem cell injections for osteoarthritis of the knee should continue to be studied in rigorous trials [1].
• More knowledge regarding the biological properties of MSCs and endothelial progenitor cells is required before using these cells as a routinely applied therapy in the clinical setting [3].
• The best effects of stem cell treatment for PTOA were observed on days 7 and 14 after anterior cruciate ligament transection (ACLT) in a rat model [4].
• Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [6].
• The application of mesenchymal stem cells should be guided by the pathophysiology of the target disease [6].
• The application of mesenchymal stem cells should follow regulatory frameworks to ensure safe and effective use [6].
• Interventions employing platelet-rich plasma (PRP), mesenchymal stem cells, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [7].
• Mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources are being researched for the treatment of osteoarthritis [9].
• The outcome of mesenchymal stem cell tissue engineering approaches is influenced by the methodologies and materials used during the cycle from isolation to re-implantation [10].
• Endogenous mesenchymal stem cells can be pharmacologically mobilized into peripheral blood [11].
• Endogenous mesenchymal stem cells can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [11].
• Osteogenically pre-differentiated adipose-derived stem cells demonstrated enhanced bone regenerative capacity compared with undifferentiated adipose-derived stem cells in experimental nonunion fractures [12].
• Local delivery of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [13].
• Spin bias was present in most mesenchymal stem cell-related trials for knee osteoarthritis [14].
• Spin bias was more frequent among trials that utilized adipose-derived mesenchymal stem cells [14].
• The superiority of bone marrow aspirate concentrate (BMAC) over other orthobiologic treatments cannot be assessed given the conflicting results presently available [15].
• Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) was shown to be a viable therapeutic option for knee osteoarthritis combined with synovitis [16].
• Treatment with UC-MSCs showed clinical improvement at the end of follow-up for knee osteoarthritis combined with synovitis [16].
• Clinical improvement with UC-MSCs was especially observed in patients with moderate to severe pain [16].
• Arthroscopic surgical repair combined with mesenchymal stem cell augmentation reported better structural outcomes compared to isolated surgical repair for rotator cuff tears [19].

Practical Considerations

• The best effects for stem cell treatment of PTOA are observed on days 7 and 14 after anterior cruciate ligament transection [4].
• Interventions employing platelet-rich plasma (PRP), mesenchymal stem cells, and exosomes are considered for degenerative osteoarthritis [7].
• Mesenchymal stem cell-derived exosomes from diverse tissue sources are being researched for the treatment of osteoarthritis [9].
• Spin bias was present in most mesenchymal stromal cell-related trials for knee osteoarthritis [14].
• Spin bias had a higher frequency among trials that utilized adipose-derived mesenchymal stromal cells [14].
• Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) is a viable therapeutic option for knee osteoarthritis combined with synovitis [16].
• UC-MSC treatment showed clinical improvement at the end of follow-up for knee osteoarthritis combined with synovitis [16].
• UC-MSC treatment showed clinical improvement especially in patients with moderate to severe pain [16].
• Certain local anesthetics, corticosteroids, and anticoagulants should be avoided when possible to preserve mesenchymal stem cell viability for BMAC procedures [21].

Key Evidence

• [L1] There is insufficient evidence to recommend stem cell injections in clinical practice at this time, but they should continue to be studied in rigorous trials. [1] (10.1097/corr.0000000000003593)
• [L2] MSC injections represent a growing area of research in traumatology and orthopaedics. [2] (10.1186/s12891-025-09123-8)
• [L5] Even though MSCs and EPCs constitute a powerful candidate cell type for regenerative medicine, more knowledge in terms of their biological properties is required before using these cells as a routinely applied therapy in the clinical setting. [3] (10.1016/s0020-1383(08)70012-3)
• [L5] The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for PTOA, with the best effects observed on days 7 and 14 after ACLT. [4] (10.1177/03635465251326499)
• [L5] Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis, though a better understanding of their mechanisms and standardized isolation methods is required before clinical application. [5] (10.1016/j.jhsa.2023.11.016)
• [L5] Mesenchymal stem cells (MSCs) have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations, but their application should be guided by the pathophysiology of the target disease and follow regulatory frameworks to ensure safe and effective use. [6] (10.1530/eor-2026-0056)
• [L5] Interventions employing PRP, MSCs and exosomes are considered in this article. [7] (10.1016/j.reth.2020.07.007)
• [L5] Repeated intra-articular injections of PRP and ADSCs alleviated inflammation and pain, promoted tissue repair, and modulated immune responses in rats with surgically induced OA. [8] (10.1186/s13018-024-05396-2)
• [L5] This article provides a synopsis of the research progress and mechanisms of mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources in the treatment of osteoarthritis. [9] (10.1186/s13018-026-06907-z)
• [L5] The outcome of these approaches is influenced by the methodologies and materials used during the cycle from the isolation of MSCs to their re-implantation. [10] (10.1016/s0020-1383(08)70006-8)
• [L5] Endogenous MSCs can be pharmacologically mobilized into peripheral blood and recruited to the site of rotator cuff repair via local delivery of MCP-1. [11] (10.1177/03635465251341439)
• [Paper] Osteogenically pre-differentiated ASCs demonstrated enhanced bone regenerative capacity compared with undifferentiated ASCs. [12] (10.1186/s12891-026-10114-6)
• [L5] Local delivery of MSC-EVs embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy. [13] (10.1177/03635465261421555)
• [L2] Spin bias was present in most MSC-related trials for knee osteoarthritis, with a higher frequency among those that utilized adipose-derived MSCs. [14] (10.1177/03635465241274155)
• [L2] However, the superiority of BMAC over other orthobiologic treatments cannot be assessed given the conflicting results presently available. [15] (10.1186/s13018-025-06509-1)
• [L1] Treatment with UC-MSCs was shown to be a viable therapeutic option for KOA combined with synovitis, showing clinical improvement at the end of follow-up, especially in those with moderate to severe pain. [16] (10.1186/s12891-025-09440-y)
• [L5] These findings provide a theoretical rationale and identify promising therapeutic targets for the development of exosome-based therapeutic strategies against OA. [17] (10.1186/s13018-026-06765-9)
• [L5] Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing. [18] (10.1177/03635465241313124)
• [L1] Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. [19] (10.1016/j.jseint.2025.03.017)
• [Paper] These findings demonstrate that certain local anesthetics, corticosteroids, and anticoagulants should be avoided when possible to preserve MSC cell viability for BMAC procedures. [21] (10.1177/2325967126s00427)
• [Paper] Even in the irrigation fluid, which is normally discarded, cells with the characteristics of stromal stem cells were isolated. [22] (10.1016/s0020-1383(15)30051-6)

References

[1] Cochrane in CORR ®: Stem Cell Injections for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003593

[2] Mesenchymal stem cells injections in traumatology and orthopaedics: common practice or still a promising area with many uncertainties?. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09123-8

[3] Biological considerations of mesenchymal stem cells and endothelial progenitor cells. Injury. 2008. DOI: 10.1016/s0020-1383(08)70012-3

[4] Days 7 to 14 May Represent an Optimal Window for Stem Cell–Based Treatment in a Rat Model of Anterior Cruciate Ligament Transection–Induced Posttraumatic Osteoarthritis. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251326499

[5] The Role of Exosomes in Upper-Extremity Tissue Regeneration. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.016

[6] Clinical application of mesenchymal stem cells in orthopaedics and traumatology in daily practice. EFORT Open Reviews. 2026. DOI: 10.1530/eor-2026-0056

[7] Degenerative osteoarthritis a reversible chronic disease. Regenerative Therapy. 2020. DOI: 10.1016/j.reth.2020.07.007

[8] Adipose-derived mesenchymal stem cells combined with platelet-rich plasma are superior options for the treatment of osteoarthritis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-024-05396-2

[9] Application of exosomes derived from mesenchymal stem cells in osteoarthritis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06907-z

[10] Mesenchymal stem cell tissue engineering: Techniques for isolation, expansion and application. Injury. 2007. DOI: 10.1016/s0020-1383(08)70006-8

[11] Pharmacologic Mobilization and Chemokine-Directed Recruitment of Mesenchymal Stromal Cells to the Surgically Repaired Rotator Cuff. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251341439

[12] Evaluation of mesenchymal stem cells’ bone repair capacity via osteogenic lineage differentiation in experimental nonunion fractures. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-10114-6

[13] Regenerative Effect of Injectable Collagen Loaded With Mesenchymal Stem Cell–Derived Extracellular Vesicles in a Collagenase-Induced Tendinopathy Rat Model. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261421555

[14] Evaluation of Spin in Clinical Trials of Mesenchymal Stromal Cells for the Treatment of Knee Osteoarthritis: A Systematic Review. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241274155

[15] Progress in the clinical use of bone marrow aspirate concentrate for knee osteoarthritis: an expert opinion. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06509-1

[16] Intra-articular injection of umbilical cord–derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis: a double‑blinded and randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09440-y

[17] Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06765-9

[18] Bone Marrow Aspirate Concentrate Combined With an Appropriate Carrier Effectively Promotes Bone-Tendon Interface Healing in a Rabbit Model of Chronic Rotator Cuff Tear. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465241313124

[19] Combined arthroscopic rotator cuff repair with mesenchymal stem cell augmentation shows similar functional outcomes but a higher structural integrity rate compared with isolated repair: a meta-analysis of comparative studies. JSES International. 2025. DOI: 10.1016/j.jseint.2025.03.017

[21] Poster 123. Characterization of Human Bone Marrow Aspirate Concentrate Derived Mesenchymal Stem Cells and the Effect of Commonly Used Clinical Drugs on Their Viability and Proliferation. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00427

[22] RIA fractions contain mesenchymal stroma cells with high osteogenic potency. Injury. 2015. DOI: 10.1016/s0020-1383(15)30051-6