Stem Cell Versus Platelet-rich Plasma for Knee Osteoarthritis: A Systematic Review

AIM: The objective is to compare the outcomes of intra-articular injection of mesenchymal stem cells (MSCs) to platelet-rich plasma (PRP) as a treatment modality for knee osteoarthritis (OA). METHODS: Systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses and PICO criteria for the past 10 years of publications. Keywords used to search with Boolean operator: “knee OA” AND “MSCs” AND“PRP” AND “outcome.” All selected articles were assessed for their quality based on strengthening the Reporting of Observational Studies in Epidemiology checklist. RESULTS: We selected five articles of prospective cohort studies, which involved 54 patients whom received combination therapies of MSCs+PRP, 206 patients received MSCs only treatment and 86 patients received PRP only treatment. It was shown that MSCs had superior outcomes compared to PRP treatment in terms of VAS and KOOS, where combinations of MSCs and PRP treatment had no significant difference compared to the MSCs treatment alone. Nonetheless, each treatment showed a significant improvement of KOOS, VAS, WOMAC, IKDC, knee, and function knee scores from their baselines. CONCLUSION: Intra-articular injections are effective and safe for the management of knee OA. MSCs treatment has superior effect on the treatment outcomes compared to PRP treatment. Combination of both treatments is comparable to MSCs treatment alone.