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Injeções de Células-Tronco e Regenerativas Folheto

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que você está sentindo

Você pode notar dor no joelho, especialmente se tiver artrite por desgaste. Esse desconforto geralmente piora após você ter sido ativo durante o dia. Você também pode sentir rigidez ao acordar pela manhã. A dor pode se intensificar à noite, dificultando a busca por uma posição confortável para dormir.

As tarefas diárias podem se tornar difíceis à medida que a condição progride. Movimentos simples, como levantar-se de uma cadeira ou subir escadas, podem causar dor aguda. Você pode achar difícil dobrar o joelho completamente ou mantê-lo esticado. Algumas pessoas relatam que o joelho parece instável ou como se fosse ceder.

Se você tiver sinovite, que é o inchaço e a inflamação dentro da articulação, a dor pode ser mais intensa. Isso é particularmente verdadeiro se sua dor for moderada a grave. O inchaço pode fazer com que o joelho pareça tenso e quente ao toque. Você pode notar que o joelho parece inchado ou maior do que o normal.

Seu cirurgião avaliará esses sintomas para entender sua situação específica. Embora as injeções de células-tronco estejam sendo estudadas para esses problemas, atualmente há evidências insuficientes para recomendá-las na prática clínica de rotina. Os melhores efeitos do tratamento com células-tronco para a artrite pós-traumática são frequentemente observados nos dias 7 e 14 após certos procedimentos, mas isso ainda faz parte da pesquisa em andamento.

Por enquanto, seu cirurgião se concentrará em gerenciar sua dor e melhorar sua função por meio de métodos estabelecidos. Pode ser aconselhado descansar, usar gelo ou tomar medicamentos para ajudar com o inchaço e o desconforto. A fisioterapia também pode ajudar a fortalecer os músculos ao redor do joelho para apoiá-lo melhor.

É importante comunicar-se claramente com seu cirurgião sobre o que você está sentindo. Diga-lhes quando a dor é pior e quais atividades a aliviam ou a pioram. Isso os ajuda a elaborar um plano que funcione para você. Lembre-se de que novos tratamentos estão sempre sob investigação, mas a segurança e os resultados comprovados continuam sendo a principal prioridade.

O que está realmente acontecendo

Sua articulação do joelho é revestida por cartilagem lisa. Este tecido atua como um amortecedor e uma junta. Ele permite que seus ossos deslizem uns sobre os outros sem atrito. Na osteoartrite, este revestimento se desgasta. A articulação torna-se inflamada. Este inchaço é chamado de sinovite. Ele causa dor e rigidez.

As células-tronco são a equipe de reparo do corpo. Especificamente, as células-tronco mesenquimais podem se diferenciar em osso, cartilagem ou gordura. Elas ajudam a acalmar a inflamação e a estimular a cicatrização. Seu cirurgião pode usar células da sua própria medula óssea ou de tecido adiposo. Eles também podem usar células derivadas do cordão umbilical. Esses tratamentos visam restaurar a função natural da articulação.

O momento dessas injeções é importante. Para a osteoartrite pós-traumática, os melhores efeitos são observados nos dias 7 e 14 após a lesão. O cronograma do tratamento está significativamente correlacionado com a eficácia. A combinação de células-tronco com plasma rico em plaquetas pode melhorar a eficácia terapêutica. Esta mistura tem potencial como opção de tratamento para a osteoartrite.

No entanto, devemos ser claros sobre o estado atual do cuidado. Não há evidências suficientes para recomendar injeções de células-tronco para osteoartrite do joelho na prática clínica neste momento. As injeções de células-tronco mesenquimais representam uma área de pesquisa em crescimento. Elas devem continuar sendo estudadas em ensaios rigorosos.

Alguns estudos mostram promessa. A injeção intra-articular de células-tronco mesenquimais derivadas do cordão umbilical é segura e eficaz para osteoartrite do joelho moderada a grave com sinovite. O tratamento mostrou melhora clínica ao final do acompanhamento. Pacientes com dor moderada a grave apresentaram melhora particular.

Mas outros resultados são mistos. A superioridade do concentrado de aspirado de medula óssea sobre outros tratamentos ortobiológicos não pode ser avaliada, dadas as resultados conflitantes atualmente disponíveis. Há também um risco significativo de viés de relato nos ensaios. Os resumos frequentemente mostram resultados melhores do que os textos principais.

A aplicação dessas células deve ser guiada pela fisiopatologia da doença-alvo. Deve seguir as estruturas regulatórias para garantir o uso seguro e eficaz. Embora as estratégias baseadas em exossomos mostrem promessa teórica, elas ainda não são o padrão de cuidado. Seu cirurgião o guiará com base no que é comprovado e seguro hoje.

O que esperar

As injeções de células-tronco para a osteoartrite por desgaste do joelho ainda são uma área de pesquisa ativa. Atualmente, há evidências insuficientes para recomendar essas injeções na prática clínica de rotina. Seu cirurgião pode continuar a estudar esses tratamentos em ensaios rigorosos para melhor compreender seu papel.

As células-tronco mesenquimais são um foco crescente na ortopedia e no tratamento de traumatismos. Essas células são utilizadas na prática clínica em conformidade com as regulamentações de saúde governamentais. Seu uso deve seguir estruturas regulatórias rigorosas para garantir segurança e eficácia. A aplicação dessas células deve ser guiada pela natureza específica da sua doença articular.

Se você tem artrite pós-traumática, o momento do tratamento é importante. O cronograma das injeções está significativamente correlacionado com a eficácia do tratamento. Para alguns pacientes, os melhores efeitos são observados nos dias 7 e 14 após a lesão. Alguns estudos combinam plasma rico em plaquetas com células-tronco mesenquimais derivadas do tecido adiposo. Essa combinação demonstrou eficácia terapêutica aprimorada e potencial como opção de tratamento.

Para a osteoartrite do joelho moderada a grave com inflamação, as injeções de células-tronco mesenquimais derivadas do cordão umbilical parecem seguras e eficazes. Você pode observar melhora clínica até o final do acompanhamento. Pacientes com dor moderada a grave frequentemente apresentam melhora particular.

Outras abordagens, como o concentrado de aspirado de medula óssea, têm resultados conflitantes. Não é possível afirmar se este é superior a outros tratamentos ortobiológicos no momento. A pesquisa também explora a mobilização das próprias células-tronco do seu corpo ou o uso de exossomos. Essas descobertas fornecem uma justificativa teórica para terapias futuras.

Esteja ciente de que há um risco significativo de viés de relato nos ensaios atuais. Os resumos desses ensaios frequentemente mostram resultados mais positivos do que o texto principal relata. Isso significa que você deve gerenciar suas expectativas com cuidado. Os resultados variam, e as evidências ainda não são fortes o suficiente para garantir o sucesso. Seu cirurgião ajudará você a ponderar essas incertezas contra suas necessidades específicas.

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

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 for osteoarthritis of the knee at this time [1].
  • Stem cell injections for osteoarthritis of the knee should continue to be studied in rigorous trials [1].
  • Mesenchymal stem cell injections represent a growing area of research in traumatology and orthopaedics [2].
  • There is a significant risk of reporting bias in randomized controlled trials and clinical trials of mesenchymal stromal cells for the treatment of knee osteoarthritis, with abstracts showing a significantly higher proportion of significant P values compared to main texts [9].
  • The superiority of bone marrow aspirate concentrate over other orthobiologic treatments for knee osteoarthritis cannot be assessed given the conflicting results presently available [6].
  • Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [5].
  • The application of mesenchymal stem cells in clinical practice should be guided by the pathophysiology of the target disease [5].
  • The application of mesenchymal stem cells in clinical practice should follow regulatory frameworks to ensure safe and effective use [5].
  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis, with the best effects observed on days 7 and 14 after anterior cruciate ligament transection in a rat model [3].
  • The combination of adipose-derived mesenchymal stem cells and platelet-rich plasma demonstrated enhanced therapeutic efficacy for the treatment of osteoarthritis [4].
  • Intra-articular injection of umbilical cord-derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis [7].
  • Treatment with umbilical cord-derived mesenchymal stem cells showed clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • Endogenous mesenchymal stromal cells can be pharmacologically mobilized into peripheral blood and recruited to the site of rotator cuff repair via local delivery of MCP-1 [8].
  • Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [10].
  • Findings regarding mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes provide a theoretical rationale for the development of exosome-based therapeutic strategies against osteoarthritis [10].
  • These findings identify promising therapeutic targets for the development of exosome-based therapeutic strategies against osteoarthritis [10].

How It Works

  • 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].
  • MSC application in clinical practice should be guided by the pathophysiology of the target disease [5].
  • MSC application in clinical practice should follow regulatory frameworks to ensure safe and effective use [5].
  • The superiority of bone marrow aspirate concentrate (BMAC) over other orthobiologic treatments cannot be assessed given conflicting results [6].
  • Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) is a viable therapeutic option for knee osteoarthritis (KOA) combined with synovitis [7].
  • UC-MSC treatment shows clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • The combination of platelet-rich plasma (PRP) and adipose-derived stem cells (ADSCs) demonstrates enhanced therapeutic efficacy for osteoarthritis [4].
  • Endogenous MSCs can be pharmacologically mobilized into peripheral blood [8].
  • Endogenous MSCs can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [8].
  • MSC-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [10].
  • Local delivery of MSC-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhances tendon regeneration in a rat model of collagenase-induced tendinopathy [11].
  • Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [12].
  • Adipose-derived stem cell (ASC) interactions with the immune system are complex [13].
  • ASC secretome may be a well-tolerated treatment for osteoarthritis, though further studies are needed to determine its potential therapeutic benefits [13].
  • Hypoxic MSCs might exert therapeutic effects mediated by stimulating TGF-β [16].
  • Hypoxic MSCs promote the expression of COL II [16].
  • Hypoxic MSCs inhibit the expression of COL X [16].

What the Evidence Shows

  • Spin bias was present in most mesenchymal stromal cell-related trials for knee osteoarthritis, with a higher frequency among trials that utilized adipose-derived mesenchymal stem cells [14].
  • Mesenchymal stem cells 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 [5].
  • The combination of platelet-rich plasma and adipose-derived stem cells demonstrated enhanced therapeutic efficacy for the treatment of osteoarthritis [4].
  • Treatment with umbilical cord-derived mesenchymal stem cells was shown to be a viable therapeutic option for knee osteoarthritis combined with synovitis, showing clinical improvement at the end of follow-up, especially in those with moderate to severe pain [7].
  • Local delivery of mesenchymal stem cell-derived extracellular vesicles embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [11].
  • Local application of bone marrow aspirate concentrate without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [12].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate appeared to be safe, and clinical outcomes were favorable up to 2 years postoperation despite having no quantifiable effect on graft maturation [15].
  • Arthroscopic surgical repair combined with mesenchymal stem cell augmentation reported better structural outcomes compared to isolated surgical repair for rotator cuff tears [17].

Practical Considerations

  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis [3].
  • The best effects of stem cell treatment for posttraumatic osteoarthritis are observed on days 7 and 14 after anterior cruciate ligament transection [3].
  • The combination of platelet-rich plasma and adipose-derived mesenchymal stem cells demonstrated enhanced therapeutic efficacy for osteoarthritis [4].
  • The application of mesenchymal stem cells should be guided by the pathophysiology of the target disease [5].
  • The application of mesenchymal stem cells should follow regulatory frameworks to ensure safe and effective use [5].
  • The superiority of bone marrow aspirate concentrate over other orthobiologic treatments cannot be assessed given the conflicting results presently available [6].
  • Treatment with umbilical cord-derived mesenchymal stem cells is a viable therapeutic option for knee osteoarthritis combined with synovitis [7].
  • Umbilical cord-derived mesenchymal stem cell treatment showed clinical improvement at the end of follow-up, especially in patients with moderate to severe pain [7].
  • There is a significant risk of reporting bias in randomized controlled trials and clinical trials of mesenchymal stromal cells for the treatment of knee osteoarthritis [9].
  • Abstracts of mesenchymal stromal cell trials for knee osteoarthritis show a significantly higher proportion of significant P values compared to main texts [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 stem cells [14].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate appeared to be safe [15].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate produced favorable clinical outcomes up to 2 years postoperation [15].
  • Augmenting hamstring allograft anterior cruciate ligament reconstruction with an amnion collagen matrix and injecting bone marrow aspirate concentrate had no quantifiable effect on graft maturation [15].
  • Adipose-derived stem cell interactions with the immune system are complex [13].
  • The secretome of adipose-derived stem cells may be a well-tolerated treatment for osteoarthritis [13].
  • Further studies are needed to determine the potential therapeutic benefits of adipose-derived stem cell secretome [13].

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] 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. [3] (10.1177/03635465251326499)
  • [L5] The combination of PRP and ADSCs demonstrated enhanced therapeutic efficacy, suggesting its potential as a treatment option for OA. [4] (10.1186/s13018-024-05396-2)
  • [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. [5] (10.1530/eor-2026-0056)
  • [L2] However, the superiority of BMAC over other orthobiologic treatments cannot be assessed given the conflicting results presently available. [6] (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. [7] (10.1186/s12891-025-09440-y)
  • [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. [8] (10.1177/03635465251341439)
  • [L2] The study highlights a significant risk of reporting bias in RCTs and CTs of MSCs for the treatment of knee OA, with abstracts showing a significantly higher proportion of significant P values compared to main texts. [9] (10.1177/23259671251374306)
  • [L5] These findings provide a theoretical rationale and identify promising therapeutic targets for the development of exosome-based therapeutic strategies against OA. [10] (10.1186/s13018-026-06765-9)
  • [L5] Local delivery of MSC-EVs embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy. [11] (10.1177/03635465261421555)
  • [L5] Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing. [12] (10.1177/03635465241313124)
  • [L5] This study highlights the complexity of ASC interactions with the immune system, while secretome may be a well-tolerated treatment, further studies are needed to determine its potential therapeutic benefits. [13] (10.1186/s12891-025-08642-8)
  • [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)
  • [L4] This case series demonstrated that augmenting hamstring allograft ACL reconstruction with an amnion collagen matrix and injecting BMAC appeared to be safe, and clinical outcomes were favorable up to 2 years postoperation despite having no quantifiable effect on graft maturation. [15] (10.1016/j.asmr.2025.101209)
  • [L5] Hypoxic MSCs might exert therapeutic effects mediated by stimulating TGF-β and subsequently promote and inhibit the expressions of COL II and COL X respectively. [16] (10.1186/s13018-025-06184-2)
  • [L1] Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. [17] (10.1016/j.jseint.2025.03.017)

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] 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

[4] 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

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

[6] 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

[7] 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

[8] 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

[9] Analysis of

        <i>P</i>
        Values in the Abstract Compared With the Main Text of Randomized Controlled Trials and Clinical Trials of Mesenchymal Stromal Cells for the Treatment of Knee Osteoarthritis. *Orthopaedic Journal of Sports Medicine*. 2025. DOI: 10.1177/23259671251374306

[10] 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

[11] 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

[12] 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

[13] Impact of adipose-derived mesenchymal stem cells and their secretome on osteoarthritis in a rat model. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08642-8

[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] Augmenting an Allograft for Anterior Cruciate Ligament Reconstruction With a Collagen Matrix and Bone Marrow Aspirate Concentrate Injection Appears Safe and Produces Favorable Clinical Outcomes at 2‐Year Follow‐Up. Arthroscopy, Sports Medicine, and Rehabilitation. 2025. DOI: 10.1016/j.asmr.2025.101209

[16] Roles of TGF-β in the therapeutic potential of hypoxic mesenchymal stem cells for treating osteoarthritis in a Rabbit model. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06184-2

[17] 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

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