Cell therapy in XXXX .

@entity2720 @entity1 @entity571
CONTEXT: Articular cartilage possesses poor natural healing mechanisms, and a variety of non-cell-based and cell-based treatments aim to promote regeneration of hyaline cartilage. DATA SOURCES: A review of the literature to December 2013 using PubMed with search criteria including the keywords stem cell, cell therapy, cell transplantation, cartilage, chondral, and chondrogenic. STUDY SELECTION: Forty-five articles were identified that employed local mesenchymal stem cell (MSC) therapy for @entity2720 in @entity1 . Nine comparative studies were identified, consisting of 3 randomized trials, 5 cohort studies, and 1 case-control study. STUDY TYPE: Clinical review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Studies were assessed for stem cell source, method of implantation, comparison groups, and concurrent surgical techniques. RESULTS: Two studies comparing MSC treatment to autologous chondrocyte implantation found similar efficacy. Three studies reported clinical benefits with intra-articular MSC injection over non-MSC controls for cases undergoing debridement with or without marrow stimulation, although a randomized study found no significant clinical difference at 2-year follow-up but reported better 18-month magnetic resonance imaging and histologic scores in the MSC group. No @entity1 studies have compared intra-articular MSC therapy to non-MSC techniques for @entity571 in the absence of surgery. CONCLUSION: Mesenchymal stem cell-based therapies appear safe and effective for @entity2720 in large animal preclinical models. Evidence for use in @entity1 , particularly, comparison with more established treatments such as autologous chondrocyte implantation and microfracture, is limited.
