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स्टेम सेल और पुनर्जनन इंजेक्शन

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What stem-cell and bone-marrow-derived injections claim to do for joints and tendons, what the evidence actually shows, and the safety and regulatory caveats.

Updated Sep 2026
एक सिरिंज के बगल में एक टेस्ट ट्यूब।
स्टेम-सेल और पुनर्जनन इंजेक्शन का व्यापक रूप से विज्ञापन किया जाता है; मस्कुलोस्केलेटल उपयोग के लिए मजबूत सबूत सीमित हैं। Kieran Hirpara 4.0

यह पृष्ठ मशीन द्वारा अनूदित है और अभी तक किसी चिकित्सक द्वारा जाँचा नहीं गया है। अंग्रेज़ी संस्करण ही आधिकारिक है।

यह क्या है

स्टेम सेल इंजेक्शन एक प्रकार का पुनर्जनन उपचार है। यह विचार क्षतिग्रस्त ऊतकों को ठीक करने में मदद करने के लिए शरीर की अपनी मरम्मत कोशिकाओं का उपयोग करना है। सबसे अधिक अध्ययन की जाने वाली कोशिकाओं को मेसेंकिमल स्टेम सेल (एमएससी) कहा जाता है। ये अस्थि मज्जा और वसा में पाए जाते हैं, और वे हड्डी या उपास्थि जैसे अन्य ऊतक प्रकारों में बदल सकते हैं।

यह ऑर्थोपेडिक्स और आघात देखभाल में अनुसंधान का एक बढ़ता क्षेत्र है [1]. इसे पहनने और फाड़ने वाले गठिया (ओस्टियोआर्थराइटिस), कंधे की चोटों और फ्रैक्चर जैसी समस्याओं के लिए माना जाता है जो ठीक होने में विफल रहे हैं। कुछ संबंधित उपचार प्लेटलेट-समृद्ध प्लाज्मा (पीआरपी) का उपयोग करते हैं, जो आपके अपने रक्त से बनाया गया एकाग्र पदार्थ है। अन्य एक्सोसोम का उपयोग करते हैं, जो स्टेम सेल द्वारा जारी किए गए छोटे कण हैं। एक्सोसोम आपके शरीर से कोशिकाओं को लेने की आवश्यकता के बिना काम कर सकते हैं, इसलिए वे स्टेम सेल थेरेपी के कुछ नुकसानों से बचते हैं, जैसे कि संग्रह स्थल पर दर्द [2].

शोधकर्ताओं का मानना है कि ये उपचार कुछ तरीकों से काम करते हैं। कोशिकाएं सूजन को शांत कर सकती हैं, मरम्मत को प्रोत्साहित कर सकती हैं और नए ऊतकों के विकास को बढ़ावा दे सकती हैं [3]. कुछ दृष्टिकोण उपचार को जोड़ते हैं, उदाहरण के लिए वसा-व्युत्पन्न स्टेम कोशिकाओं के साथ पीआरपी, जिसने अनुसंधान सेटिंग्स में ऑस्टियोआर्थराइटिस के लिए बेहतर परिणाम दिखाए [4].

यह जानना महत्वपूर्ण है कि विज्ञान कहां खड़ा है। स्टेम सेल इंजेक्शन को नियमित उपचार के रूप में अनुशंसित करने के लिए अभी तक पर्याप्त सबूत नहीं हैं [5]. इन कोशिकाओं के व्यवहार के बारे में अधिक जानने की जरूरत है इससे पहले कि इनका व्यापक रूप से उपयोग किया जा सके [3]. कुछ अध्ययन आशाजनक हैं। उदाहरण के लिए, संयुक्त अस्तर सूजन (सिनोवाइटिस) के साथ घुटने के गठिया के एक अध्ययन में विशेष रूप से मध्यम से गंभीर दर्द वाले लोगों में सुधार पाया गया। [6]. लेकिन इस काम का अधिकतर प्रारंभिक चरण में है।

यदि आपका डॉक्टर आपके साथ इस विकल्प पर चर्चा करता है, तो यह उस संदर्भ में होगा: एक विकसित उपचार, सरकारी स्वास्थ्य नियमों के भीतर पेश किया जाता है [7], और केवल जहां सबूत आपकी विशिष्ट स्थिति के लिए इसका समर्थन करते हैं।

क्या यह काम करता है?

ईमानदार उत्तर यह है कि यह स्थिति पर निर्भर करता है, और सबूत अभी भी विकसित हो रहे हैं। घुटने के पहनने और आंसू के गठिया के लिए, कुछ परीक्षणों में दर्द में सुधार पाया गया, खासकर उन लोगों में जो मध्यम से गंभीर दर्द के साथ शुरू हुए थे [1]. लेकिन वहाँ एक पकड़ है। इन परीक्षणों की एक समीक्षा में पाया गया कि कई रिपोर्ट किए गए परिणाम इस तरह से थे कि उपचार वास्तव में बेहतर दिखता था। [2] [3]. इससे यह जानना मुश्किल हो जाता है कि उपचार वास्तव में कितना अच्छा काम करता है।

टेंडन और लिगामेंट की समस्याओं के लिए, चित्र मिश्रित है। जब रोटेटर कफ के आंसू के लिए कीहोल सर्जरी के साथ स्टेम सेल ट्रीटमेंट जोड़ा गया, तो मरम्मत की गई टेंडन अकेले सर्जरी की तुलना में स्कैन पर बेहतर दिखती है [4]. घुटने के लिगामेंट के पुनर्निर्माण के लिए, अस्थि मज्जा केंद्रित जोड़ना सुरक्षित प्रतीत होता है, और लोग इसके बाद 2 साल तक अच्छा करते हैं [5]. लेकिन उसी अध्ययन में पाया गया कि जोड़े गए कोशिकाओं से कोई फर्क नहीं पड़ता कि नया बंधन कितनी अच्छी तरह से हड्डी में ठीक हो जाता है [5]. दूसरे शब्दों में, सुरक्षित, लेकिन अभी तक कोई स्पष्ट अतिरिक्त लाभ नहीं।

कुछ ऐसी चीजें भी हैं जो शोधकर्ताओं को अभी तक पता नहीं हैं। कोशिकाओं को तैयार करने और वितरित करने के विभिन्न तरीके परिणाम को बदल सकते हैं [6]. कुछ कोशिका-आधारित उपचारों की तुलना अभी तक निष्पक्ष रूप से नहीं की जा सकती है, क्योंकि मौजूदा अध्ययन अलग-अलग दिशाओं की ओर इशारा करते हैं [7]. नए विकल्प, जैसे एक्सोसोम, परीक्षण के शुरुआती चरण में हैं [8].

तो यह आपको कहां छोड़ता है? स्टेम सेल इंजेक्शन अधिकांश आर्थोपेडिक समस्याओं के लिए एक सिद्ध, नियमित उपचार नहीं है [9]. वे कुछ लोगों को कुछ स्थितियों में मदद कर सकते हैं। यदि आपका डॉक्टर आपके साथ इस विकल्प पर चर्चा करता है, तो उन्हें स्पष्ट होना चाहिए कि साक्ष्य के कौन से हिस्से मजबूत हैं और कौन से नहीं हैं।

जोखिम क्या हैं?

ईमानदार जवाब यह है कि शोधकर्ता अभी भी पूरी जोखिम तस्वीर पर काम कर रहे हैं। अब तक के अधिकांश अध्ययन छोटे रहे हैं, और कुछ ने अपने परिणामों को इस तरह से बताया है कि उपचार वास्तव में बेहतर दिखता है [1] [2]. इससे यह स्पष्ट रूप से पढ़ना कठिन हो जाता है कि समस्याएं कितनी बार होती हैं।

अब तक शोधकर्ताओं ने जो देखा है वह हानियों की गणना करने के बजाय सुरक्षा संकेतों के बारे में अधिक है। जब एक अस्थि मज्जा एकाग्रता घुटने लिगामेंट पुनर्निर्माण सर्जरी में जोड़ा गया था, अध्ययन ने बताया कि यह सुरक्षित प्रतीत होता है [3]. वसा-व्युत्पन्न स्टेम कोशिकाओं के सिग्नलिंग कणों से बने उपचार के लिए, प्रारंभिक कार्य में पाया गया कि यह अच्छी तरह से सहन किया जा सकता है [4]. लेकिन ये निष्कर्ष एक चेतावनी के साथ आते हैं। उसी शोध में कहा गया है कि वास्तविक लाभों को जानने से पहले अधिक अध्ययनों की आवश्यकता है [4].

उपचार कैसे तैयार और दिया जाता है, इसके बारे में भी खुले प्रश्न हैं। जिस तरह से कोशिकाओं को संभाला जाता है, जब से उन्हें एकत्र किया जाता है जब तक वे आपके शरीर में वापस डाल दिए जाते हैं, परिणाम बदल सकते हैं [5]. एक पशु अध्ययन में, अस्थि मज्जा एकाग्रता को अपने आप लागू किया गया, इसे रखने के लिए एक वाहक सामग्री के बिना, हड्डी के लिए नस को ठीक करने में मदद नहीं की [6]. यह महत्वपूर्ण है क्योंकि यह सुझाव देता है कि तकनीक और सेटिंग का हिस्सा हैं कि क्या उपचार के रूप में कार्य करता है, न कि केवल कोशिकाओं को ही।

एक और बात जानने लायक है। चूंकि इन उपचारों का अध्ययन अभी भी किया जा रहा है, इसलिए उन्हें केवल सरकारी स्वास्थ्य विनियमों के भीतर ही पेश किया जाना चाहिए, जिसमें विशिष्ट स्थिति का इलाज किया जा रहा है [7]. यदि आपका डॉक्टर इस विकल्प को उठाता है, तो पूछें कि आपकी विशेष समस्या के लिए सुरक्षा के बारे में क्या जाना जाता है, और क्या नहीं है।

क्या यह आपके लिए सही है?

ये इंजेक्शन पहनने और आंसू गठिया के लिए, और कुछ टेंडन, लिगामेंट और फ्रैक्चर हीलिंग समस्याओं के लिए माना जाता है [1]. अनुसंधान ने उन्हें घुटने के गठिया में सबसे अधिक देखा है, जिसमें संयुक्त अस्तर सूजन वाले लोग शामिल हैं [2]. उन्हें घुटने के लिगामेंट पुनर्निर्माण सर्जरी के साथ भी अध्ययन किया गया है [3].

यदि आपको मध्यम से गंभीर गठिया का दर्द है, तो आप उनके अनुरूप हो सकते हैं, क्योंकि यह वह समूह है जहां सुधार सबसे स्पष्ट रूप से दिखाया गया है [2]. जब कोई फ्रैक्चर सामान्य तरीके से ठीक नहीं हो पाता है, तब भी उन पर विचार किया जा सकता है [4].

वे शायद आपके लिए सही नहीं हैं यदि आप एक सिद्ध, नियमित उपचार की उम्मीद करते हैं। सबूत अभी तक इस बात का समर्थन नहीं करते हैं कि [5]. कुछ नए विकल्प, जैसे कि एक्सोसोम, अभी भी परीक्षण के शुरुआती चरण में हैं [6]. और एक अध्ययन में पाया गया कि जोड़े गए कोशिकाओं से कोई फर्क नहीं पड़ता कि कैसे एक नया घुटने के बंधन हड्डी में ठीक हो जाता है [3], इसलिए अतिरिक्त उपचार हमेशा लाभ नहीं जोड़ता है।

मुख्य विकल्पों की तुलना में, जैसे कि मानक सर्जरी या स्थापित गैर-सर्जिकल देखभाल, ये इंजेक्शन एक अलग स्थान पर बैठते हैं। इनका अभी भी अध्ययन किया जा रहा है, इसलिए इन्हें सरकारी स्वास्थ्य विनियमों के भीतर और आपकी विशिष्ट स्थिति द्वारा निर्देशित किया जाता है [7].

जोखिमों का अपना उपरोक्त खंड है, इसलिए निर्णय लेने से पहले इसे पढ़ें।

यह आपके डॉक्टर के साथ साझा निर्णय होना चाहिए। पूछें कि साक्ष्य के कौन से हिस्से आपकी स्थिति के लिए मजबूत हैं, और कौन से नहीं हैं। यदि उत्तर स्पष्ट नहीं है, तो एक अच्छी तरह से स्थापित उपचार आपके लिए बेहतर काम कर सकता है।

निचली रेखा

स्टेम सेल इंजेक्शन का अभी भी अध्ययन किया जा रहा है, नियमित देखभाल नहीं। वे पहनने और आंसू गठिया के लिए विचार करने के लायक हो सकते हैं, खासकर यदि आपका दर्द मध्यम से गंभीर है [1]. कुछ नए विकल्प, जैसे कि एक्सोसोम, परीक्षण के शुरुआती चरण में हैं [2]. यथार्थवादी उम्मीदों के साथ जाएंः वे कुछ स्थितियों के साथ कुछ लोगों की मदद कर सकते हैं, और जिस तरह से परीक्षणों में परिणामों की सूचना दी गई है, यह जानना मुश्किल है कि वे वास्तव में कितना अच्छा काम करते हैं [3] [4]. सबसे महत्वपूर्ण चेतावनी यह है। यदि आपका डॉक्टर इस विकल्प पर चर्चा करता है, तो यह सरकारी स्वास्थ्य नियमों के भीतर होना चाहिए और आपकी विशिष्ट स्थिति द्वारा निर्देशित होना चाहिए [5]. यदि आपकी समस्या का प्रमाण स्पष्ट नहीं है, तो एक अच्छी तरह से स्थापित उपचार आपको बेहतर सेवा दे सकता है।

संदर्भ

[1] ट्रॉमाटोलॉजी और ऑर्थोपेडिक्स में मेसेंकिमल स्टेम सेल इंजेक्शनः सामान्य अभ्यास या अभी भी कई अनिश्चितताओं के साथ एक आशाजनक क्षेत्र? बीएमसी मस्कुलोस्केलेटल विकार2025 तक। डीओआईः 10.1186/s12891-025-09123-8

[2] ऊपरी-अंत ऊतक पुनर्जनन में एक्सोसोम की भूमिका। द जर्नल ऑफ हैंड सर्जरी. 2024. डीओआईः 10.1016/j.jhsa.2023.11.016

[3] मेसेंकिमल स्टेम सेल्स और एंडोथेलियल प्रोजेनटर सेल्स के जैविक विचार चोट२००८। डीओआईः 10.1016/s0020-1383(08)70012-3

[4] ऑस्टियोआर्थराइटिस के उपचार के लिए प्लेटलेट-समृद्ध प्लाज्मा के साथ संयुक्त एडिपोस-व्युत्पन्न मेसेंकिमल स्टेम सेल बेहतर विकल्प हैं। जर्नल ऑफ ऑर्थोपेडिक सर्जरी एंड रिसर्च2025 तक। डीओआईः 10.1186/s13018-024-05396-2

[5] CORR ® में कोक्रेन: घुटने के गठिया के लिए स्टेम सेल इंजेक्शन। क्लिनिकल ऑर्थोपेडिक्स और संबंधित अनुसंधान2025 तक। डीओआईः 10.1097/corr.0000000000003593

[6] नाभिबंधन से प्राप्त मेसेंकिमल स्टेम सेल का इंट्रा-आर्टिकुलर इंजेक्शन मध्यम से गंभीर घुटने के ऑस्टियोआर्थराइटिस के लिए सुरक्षित और प्रभावी हैः एक डबल-ब्लाइंड और यादृच्छिक नियंत्रित परीक्षण। बीएमसी मस्कुलोस्केलेटल विकार2025 तक। डीओआईः 10.1186/s12891-025-09440-y

[7] दैनिक अभ्यास में आर्थोपेडिक्स और ट्रॉमाटोलॉजी में मेसेंकिमल स्टेम कोशिकाओं का नैदानिक अनुप्रयोग। एफोर्ट ओपन रिव्यूज२०२६। डीओआईः 10.1530/eor-2026-0056

[8] घुटने के ऑस्टियोआर्थराइटिस के उपचार के लिए मेसेंकिमल स्ट्रॉमल कोशिकाओं के नैदानिक परीक्षणों में स्पिन का मूल्यांकन: एक व्यवस्थित समीक्षा। अमेरिकन जर्नल ऑफ स्पोर्ट्स मेडिसिन2025 तक। डीओआईः 10.1177/03635465241274155

[9] का विश्लेषण

[10] मेसेंकिमल स्टेम सेल वृद्धि के साथ संयुक्त आर्थ्रोस्कोपिक रोटेटर कफ की मरम्मत से अलग-अलग मरम्मत की तुलना में समान कार्यात्मक परिणाम दिखाई देते हैं लेकिन एक उच्च संरचनात्मक अखंडता दरः तुलनात्मक अध्ययनों का मेटा-विश्लेषण। जेएसईएस इंटरनेशनल2025 तक। डीओआईः 10.1016/j.jseint.2025.03.017

[11] कोलेजन मैट्रिक्स और अस्थि मज्जा एस्पिरेट कंसंट्रेट इंजेक्शन के साथ एक एलोग्राफ्ट को एंटेरियर क्रूसिएट लिगामेंट रिकंस्ट्रक्शन के लिए बढ़ाना सुरक्षित प्रतीत होता है और 2 साल के अनुवर्ती में अनुकूल नैदानिक परिणाम उत्पन्न करता है। आर्थ्रोस्कोपी, स्पोर्ट्स मेडिसिन और पुनर्वास2025 तक। डीओआईः 10.1016/j.asmr.2025.101209

[12] मेसेंकिमल स्टेम सेल ऊतक इंजीनियरिंगः अलगाव, विस्तार और अनुप्रयोग के लिए तकनीक। चोट२००७. डीओआईः 10.1016/s0020-1383(08)70006-8

[13] घुटने के ऑस्टियोआर्थराइटिस के लिए अस्थि मज्जा एस्पिरेट केंद्रित के नैदानिक उपयोग में प्रगतिः एक विशेषज्ञ की राय। जर्नल ऑफ ऑर्थोपेडिक सर्जरी एंड रिसर्च2025 तक। डीओआईः 10.1186/s13018-025-06509-1

[14] चूहों के मॉडल में ऑस्टियोआर्थराइटिस पर एडिपस-व्युत्पन्न मेसेंकिमल स्टेम कोशिकाओं और उनके स्राव का प्रभाव। बीएमसी मस्कुलोस्केलेटल विकार2025 तक। डीओआईः 10.1186/s12891-025-08642-8

[15] अस्थि मज्जा एस्पिरेट एकाग्रता एक उपयुक्त वाहक के साथ संयुक्त रूप से क्रोनिक रोटेटर कफ आंसू के खरगोश मॉडल में हड्डी-टेंडन इंटरफेस हीलिंग को प्रभावी ढंग से बढ़ावा देता है। अमेरिकन जर्नल ऑफ स्पोर्ट्स मेडिसिन2025 तक। डीओआईः 10.1177/03635465241313124

[16] अपक्षयी ऑस्टियोआर्थराइटिस एक प्रतिवर्ती पुरानी बीमारी है। पुनर्जनन चिकित्सा. 2020 डीओआईः 10.1016/j.reth.2020.07.007

[17] मेसेंकिमल स्टेम कोशिकाओं का मूल्यांकन हड्डी की मरम्मत क्षमता के माध्यम से ऑस्टियोजेनिक वंश भेदभाव के माध्यम से प्रयोगात्मक नॉन यूनियन फ्रैक्चर में। बीएमसी मस्कुलोस्केलेटल विकार२०२६। डीओआईः 10.1186/s12891-026-10114-6

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 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].
  • More knowledge regarding the biological properties of MSCs and endothelial progenitor cells (EPCs) is required before using these cells as a routinely applied therapy in the clinical setting [3].
  • The intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for posttraumatic osteoarthritis (PTOA) [4].
  • The best effects of stem cell treatment for PTOA are observed on days 7 and 14 after anterior cruciate ligament transection (ACLT) [4].
  • Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration [5].
  • Exosomes overcome limitations such as donor-site morbidity and tumorigenesis associated with mesenchymal stem cell therapies [5].
  • A better understanding of exosome mechanisms and standardized isolation methods is required before clinical application [5].
  • Mesenchymal stem cells (MSCs) have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [6].
  • The application of MSCs should be guided by the pathophysiology of the target disease [6].
  • The application of MSCs should follow regulatory frameworks to ensure safe and effective use [6].
  • Interventions employing platelet-rich plasma (PRP), MSCs, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [7].
  • The outcome of MSC tissue engineering approaches is influenced by the methodologies and materials used during the cycle from the isolation of MSCs to their re-implantation [10].
  • Cells with the characteristics of stromal stem cells were isolated from irrigation fluid, which is normally discarded [22].

How It Works

  • Exosomes overcome limitations of mesenchymal stem cell therapies such as donor-site morbidity and tumorigenesis [5].
  • Repeated intra-articular injections of PRP and adipose-derived stem cells (ADSCs) alleviated inflammation and pain in rats with surgically induced osteoarthritis [8].
  • Repeated intra-articular injections of PRP and ADSCs promoted tissue repair in rats with surgically induced osteoarthritis [8].
  • Repeated intra-articular injections of PRP and ADSCs modulated immune responses in rats with surgically induced osteoarthritis [8].
  • Mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources are used in the treatment of osteoarthritis [9].
  • Endogenous MSCs can be pharmacologically mobilized into peripheral blood [11].
  • Endogenous MSCs can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [11].
  • Osteogenically pre-differentiated adipose-derived stem cells (ASCs) demonstrated enhanced bone regenerative capacity compared with undifferentiated ASCs in experimental nonunion fractures [12].
  • Local delivery of MSC-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [13].
  • Mesenchymal stem cell-derived miR-125b-1-3p-abundant exosomes alleviate osteoarthritis by modulating the KDM6B-H3K27me3-FOXM1 axis [17].
  • Local application of bone marrow aspirate concentrate (BMAC) without appropriate carriers could not enhance bone-tendon interface healing in a rabbit model of chronic rotator cuff tear [18].

What the Evidence Shows

  • Stem cell injections for osteoarthritis of the knee should continue to be studied in rigorous trials [1].
  • More knowledge regarding the biological properties of MSCs and endothelial progenitor cells is required before using these cells as a routinely applied therapy in the clinical setting [3].
  • The best effects of stem cell treatment for PTOA were observed on days 7 and 14 after anterior cruciate ligament transection (ACLT) in a rat model [4].
  • Mesenchymal stem cells have been used in clinical practice in orthopaedics and traumatology in accordance with government health regulations [6].
  • The application of mesenchymal stem cells should be guided by the pathophysiology of the target disease [6].
  • The application of mesenchymal stem cells should follow regulatory frameworks to ensure safe and effective use [6].
  • Interventions employing platelet-rich plasma (PRP), mesenchymal stem cells, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [7].
  • Mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources are being researched for the treatment of osteoarthritis [9].
  • The outcome of mesenchymal stem cell tissue engineering approaches is influenced by the methodologies and materials used during the cycle from isolation to re-implantation [10].
  • Endogenous mesenchymal stem cells can be pharmacologically mobilized into peripheral blood [11].
  • Endogenous mesenchymal stem cells can be recruited to the site of rotator cuff repair via local delivery of MCP-1 [11].
  • Osteogenically pre-differentiated adipose-derived stem cells demonstrated enhanced bone regenerative capacity compared with undifferentiated adipose-derived stem cells in experimental nonunion fractures [12].
  • Local delivery of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy [13].
  • Spin bias was present in most mesenchymal stem cell-related trials for knee osteoarthritis [14].
  • Spin bias was more frequent among trials that utilized adipose-derived mesenchymal stem cells [14].
  • The superiority of bone marrow aspirate concentrate (BMAC) over other orthobiologic treatments cannot be assessed given the conflicting results presently available [15].
  • Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) was shown to be a viable therapeutic option for knee osteoarthritis combined with synovitis [16].
  • Treatment with UC-MSCs showed clinical improvement at the end of follow-up for knee osteoarthritis combined with synovitis [16].
  • Clinical improvement with UC-MSCs was especially observed in patients with moderate to severe pain [16].
  • Arthroscopic surgical repair combined with mesenchymal stem cell augmentation reported better structural outcomes compared to isolated surgical repair for rotator cuff tears [19].

Practical Considerations

  • The best effects for stem cell treatment of PTOA are observed on days 7 and 14 after anterior cruciate ligament transection [4].
  • Interventions employing platelet-rich plasma (PRP), mesenchymal stem cells, and exosomes are considered for degenerative osteoarthritis [7].
  • Mesenchymal stem cell-derived exosomes from diverse tissue sources are being researched for the treatment of osteoarthritis [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 stromal cells [14].
  • Treatment with umbilical cord-derived mesenchymal stem cells (UC-MSCs) is a viable therapeutic option for knee osteoarthritis combined with synovitis [16].
  • UC-MSC treatment showed clinical improvement at the end of follow-up for knee osteoarthritis combined with synovitis [16].
  • UC-MSC treatment showed clinical improvement especially in patients with moderate to severe pain [16].
  • Certain local anesthetics, corticosteroids, and anticoagulants should be avoided when possible to preserve mesenchymal stem cell viability for BMAC procedures [21].

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] Even though MSCs and EPCs constitute a powerful candidate cell type for regenerative medicine, more knowledge in terms of their biological properties is required before using these cells as a routinely applied therapy in the clinical setting. [3] (10.1016/s0020-1383(08)70012-3)
  • [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. [4] (10.1177/03635465251326499)
  • [L5] Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis, though a better understanding of their mechanisms and standardized isolation methods is required before clinical application. [5] (10.1016/j.jhsa.2023.11.016)
  • [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. [6] (10.1530/eor-2026-0056)
  • [L5] Interventions employing PRP, MSCs and exosomes are considered in this article. [7] (10.1016/j.reth.2020.07.007)
  • [L5] Repeated intra-articular injections of PRP and ADSCs alleviated inflammation and pain, promoted tissue repair, and modulated immune responses in rats with surgically induced OA. [8] (10.1186/s13018-024-05396-2)
  • [L5] This article provides a synopsis of the research progress and mechanisms of mesenchymal stem cell-derived exosomes (MSC-Exos) from diverse tissue sources in the treatment of osteoarthritis. [9] (10.1186/s13018-026-06907-z)
  • [L5] The outcome of these approaches is influenced by the methodologies and materials used during the cycle from the isolation of MSCs to their re-implantation. [10] (10.1016/s0020-1383(08)70006-8)
  • [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. [11] (10.1177/03635465251341439)
  • [Paper] Osteogenically pre-differentiated ASCs demonstrated enhanced bone regenerative capacity compared with undifferentiated ASCs. [12] (10.1186/s12891-026-10114-6)
  • [L5] Local delivery of MSC-EVs embedded within an injectable collagen scaffold enhanced tendon regeneration in a rat model of collagenase-induced tendinopathy. [13] (10.1177/03635465261421555)
  • [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)
  • [L2] However, the superiority of BMAC over other orthobiologic treatments cannot be assessed given the conflicting results presently available. [15] (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. [16] (10.1186/s12891-025-09440-y)
  • [L5] These findings provide a theoretical rationale and identify promising therapeutic targets for the development of exosome-based therapeutic strategies against OA. [17] (10.1186/s13018-026-06765-9)
  • [L5] Local application of BMAC without appropriate carriers could not enhance bone-tendon interface healing. [18] (10.1177/03635465241313124)
  • [L1] Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. [19] (10.1016/j.jseint.2025.03.017)
  • [Paper] These findings demonstrate that certain local anesthetics, corticosteroids, and anticoagulants should be avoided when possible to preserve MSC cell viability for BMAC procedures. [21] (10.1177/2325967126s00427)
  • [Paper] Even in the irrigation fluid, which is normally discarded, cells with the characteristics of stromal stem cells were isolated. [22] (10.1016/s0020-1383(15)30051-6)

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] Biological considerations of mesenchymal stem cells and endothelial progenitor cells. Injury. 2008. DOI: 10.1016/s0020-1383(08)70012-3

[4] 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

[5] The Role of Exosomes in Upper-Extremity Tissue Regeneration. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.016

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

[7] Degenerative osteoarthritis a reversible chronic disease. Regenerative Therapy. 2020. DOI: 10.1016/j.reth.2020.07.007

[8] 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

[9] Application of exosomes derived from mesenchymal stem cells in osteoarthritis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06907-z

[10] Mesenchymal stem cell tissue engineering: Techniques for isolation, expansion and application. Injury. 2007. DOI: 10.1016/s0020-1383(08)70006-8

[11] 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

[12] Evaluation of mesenchymal stem cells’ bone repair capacity via osteogenic lineage differentiation in experimental nonunion fractures. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-10114-6

[13] 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

[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] 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

[16] 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

[17] 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

[18] 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

[19] 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

[21] Poster 123. Characterization of Human Bone Marrow Aspirate Concentrate Derived Mesenchymal Stem Cells and the Effect of Commonly Used Clinical Drugs on Their Viability and Proliferation. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00427

[22] RIA fractions contain mesenchymal stroma cells with high osteogenic potency. Injury. 2015. DOI: 10.1016/s0020-1383(15)30051-6

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a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.