Mesenchymal stem cell therapy in the sports knee: where are we in 2011?

Abstract

Background: The relationship between biological tissue healing following knee injury or surgery and long-term clinical outcome has come to the forefront of sports medicine practice. This has led many knee surgeons to incorporate biologically mediated healing factors into the management of knee injuries. In particular, the clinical use of mesenchymal stem cells has opened new horizons.

Evidence acquisition: Relevant studies were identified through a search of PubMed from January 2000 to April 2011, combining the term mesenchymal stem cells with articular cartilage, anterior cruciate ligament, and meniscus. Relevant citations from the reference lists of selected studies were also reviewed.

Results: Knee injury treatment with mesenchymal stem cells shows potential. Most reports represent animal model studies; few advances have been translated to human clinical applications.

Conclusion: Mesenchymal stem cell use to promote healing following knee injury is likely to increase. There are scientific methodological concerns and ethical and legal issues regarding mesenchymal stem cell use for treating knee injuries.

Keywords: biological tissue healing; cartilage repair; cell-based therapy.

Figure 1.

Mesenchymal stem cell (MSC) harvest, isolation, and culturing. Clinical studies have been performed with MSC injections under a periosteal patch or in combination with a scaffold to treat articular cartilage defects. Intra-articular MSC injections have also been performed clinically to treat knee articular cartilage defects. MSC use to create neoligaments, to augment graft ligamentization following anterior cruciate ligament reconstruction, and to enhance meniscal repair healing has been performed using only animal models.