Pain reduction of ≥20 points on 0–100 pain scales is achieved in 55–75% of treated knees in clinical series. Functional improvement (walking distance, stair-climbing) is reported in 50–65%. Complete cartilage restoration and pain abolition occur in <10% of cases. Older patients (>65 years), those with severe baseline OA (Kellgren–Lawrence grade 4), and those with obesity respond less robustly. Placebo analgesia (injection and attention effects) contributes measurably to outcomes, complicating true efficacy assessment in unblinded trials.
Comprehensive evidence synthesis across 166 trials remains ongoing; no systematic review with meta-analysis has been published to date. Published phase II/III trials report pain reduction (measured by WOMAC or numerical pain scales) of 30–50% in 50–70% of participants by 6 months. Imaging studies show variable results: some demonstrate cartilage thickening on MRI; others show no structural change despite pain improvement. Durability studies suggest benefit persists 12–24 months in responders. Comparative trials versus hyaluronic acid or corticosteroid injection show modest superiority of cell-based therapy. Long-term follow-up (≥5 years) in large cohorts is lacking; most evidence derives from small, single-centre studies.
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Medically reviewed by StemCellAtlas’s editorial team with Dr Tymur Lukyanenko (Orthopaedic Traumatologist · 20+ yrs clinical, 15+ yrs cell therapy) of partner clinic Stem Plus (Sofia), against ISSCR, FDA & EMA guidance. Educational information, not medical advice; figures indicative.
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