PLATELET RICH PLASMA AND STEM CELL THERAPY FOR KNEE OSTEOARTHRITIS: CLINICAL EVIDENCE AND APPLICATION
Keywords:
knee osteoarthritis, KOA, Platelet-rich plasma, PRP, stem cellsAbstract
Objective: The article is conducted in the form of an analytical and descriptive review, aiming to systematize scientific evidence and determine the scope of the overview of PRP and MSCs combined therapy in the treatment of knee osteoarthritis. Specifically, the article synthesizes and analyzes the biological basis and recent clinical evidence on combined therapy of PRP and MSCs in the treatment of knee osteoarthritis. Besides, the article aims to identify current limitations and propose directions for optimizing therapy for clinical application. Methodology and literature review: The study was designed as a review study. We performed a literature search using databases including journals from PubMed and Google Scholar from the last 5 years. In this study, we focused on evaluating the biological basis and clinical effectiveness of combined PRP and mesenchymal stem cell therapy in the treatment of knee osteoarthritis. Research outlook: The results show that combination therapy of PRP and mesenchymal stem cells offers the potential for biological resonance, contributing to improving tissue regeneration and reducing symptoms more effectively than either individual therapy in recent studies. However, current clinical evidence is still inconsistent, suggesting that more standardized trials are needed to confirm the superior benefit of this approach.
References
1. Nabavizadeh SS, Zarei M, Zare S, Koohi Hosseinabadi O, Tanideh N, Daneshi S. Attenuation of osteoarthritis progression through intra-articular injection of a combination of synovial membrane-derived MSCs (SMMSCs), platelet-rich plasma (PRP) and conditioned medium (secretome). J Orthop Surg Res. 2022;17(1):102. DOI:10.1186/s13018-021-02851-2
2. Liu X, Wang X, Virk S, Schuck K, Deveza LA, Oo WM, et al. Efficacy and cost-effectiveness of stem cell injections for symptomatic relief and structural improvement in people with tibiofemoral knee osteoarthritis: protocol for a randomised placebo-controlled trial (the SCUlpTOR trial). BMJ Open. 2021;11(11):e056382. DOI:10.1136/bmjopen-2021-056382
3. Ip HL, Nguyen DK, Sawleh SH, Kabir MH, Jahan N. Regenerative medicine for knee osteoarthritis: the efficacy and safety of intra-articular platelet-rich plasma and mesenchymal stem cells injections: a literature review. Cureus. 2020; 12(9): e10575. DOI: 10.7759/cureus.10575
4. Andia I, Sánchez A, Del Amo C, Eymard F, Bard H. The platelet-rich plasma research ecosystem: from mechanistic insights to precision treatment in knee osteoarthritis. Regener Ther. 2025; 30: 1036-1045. DOI:10.1016/j.reth.2025.10.017
5. Aixirefu A, Cui R, Wang H. Clinical efficacy of mesenchymal stem cells and platelet-rich plasma in the therapy of osteoarthritis: a meta-analysis. Am J Transl Res. 2024;16(9):4256-4267. DOI:10.62347/JUJV3321
6. Filardo G, Napoli F, Candrian C, Zaffagnini S, Grassi A. PRP injections for the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Biologics. 2021. DOI:10.1177/1947603520931170
7. Lin F, Zhang X, Cui C. Mesenchymal stem cells and platelet rich plasma therapy for knee osteoarthritis: an umbrella review of systematic reviews with meta-analysis. Ann Saudi Med. 2024; 44(3): 195-211. DOI: 10.5144/0256-4947.2024.195
8. Prodromidis AD, Moran E, Venkatesh R, Pandit H. The role of platelet-rich plasma intraarticular injections in restoring articular cartilage of osteoarthritic knees: a systematic review and meta-analysis. Osteoarthritis Cartilage Open 2022;4(4):100318. DOI:10.1016/j.ocarto.2022.100318
9. Vun J, Jones E, Ganguly P. Anti-aging potential of platelet rich plasma (PRP): evidence from osteoarthritis and applications in senescence and inflammaging. Bioengineering. 2023; 10(8):987. DOI:10.3390/bioengineering10080987
10. Hohmann E, Tetsworth K, Glatt V. Is platelet-rich plasma effective for the treatment of knee osteoarthritis? A systematic review and meta-analysis of level 1 and 2 randomized controlled trials. Eur J Orthop Surg Traumatol. 2020; 30: 955–967. DOI:10.1007/s00590-020-02623-4
11. Aixirefu A, Cui R, Wang H. Clinical efficacy of mesenchymal stem cells and platelet-rich plasma in the therapy of osteoarthritis: a meta-analysis. Am J Transl Res. 2024;16(9):4256-4267. DOI:10.62347/JUJV3321
12. Alshammary NBS. Clinical applicability of adult human mesenchymal stem cell therapy in the treatment of knee osteoarthritis. Stem Cells Cloning. 2020;13:117-136. DOI: 10.2147/sccaa.s268940
13. Zhao J, Han Y, Yang W, Xu N, Luo M, Pan J, et al. Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials. BMJ Open. 2022;12(11):e061008. DOI: 10.1136/bmjopen-2022-061008.
14. Auroux M, Mainbourg S, Chapurlat R. Efficacy of intra-articular platelet-rich plasma compared with placebo in knee osteoarthritis: a systematic review and meta-analysis. Joint Bone Spine. 2025;92(6): 105947. DOI:10.1016/j.jbspin.2025.105947
15. Zhu X, Zhang L, Riva N, Yu Z, Jiang M, Zhou F, et al. Allogeneic platelet-rich plasma for knee osteoarthritis in patients with primary immune thrombocytopenia: a randomized clinical trial. iScience. 2024;27(5):109664. DOI: 10.1016/j.isci.2024.109664
16. Prost D, Baud A, Calvo A, Aumont S, Collado H, Borne J, et al. Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: a retrospective analysis of patients optimally managed in dedicated centers. Regener Ther. 2024;25: 203-212. DOI:10.1016/j.reth.2023.12.006
17. ÜDaO E. Single vs triple injections of platelet-rich plasma in patients with knee osteoarthritis: a retrospective cohort study of 80 patients. J Cartilage Joint Preserv. 2025;5(2):100232. DOI:10.1016/j.jcjp.2024.100232.
18. Kamada K, Matsumoto T, Yamashita T, Iwaguro H, Kuroda R, Sobajima S, et al. Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich plasma for knee osteoarthritis. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2024;38:43-48. DOI: 10.1016/j.asmart.2024.09.006
19. Holiuk Y, Bukreieva T, Nemtinov P, Kyryk V, Ustymenko A, Mazevych V, et al. Effectiveness and safety of multiple injections of human placenta-derived MSCs for knee osteoarthritis: a nonrandomized phase I trial. BMC Musculoskelet Disord. 2025;26:418. DOI:10.1186/s12891-025-08664-2
20. Figueroa-Valdés AI, Herrera-Luna Y, Georges-Calderón N, García C, Tobar HE, Araya MJ, et al. Clinical-grade extracellular vesicles derived from umbilical cord mesenchymal stromal cells: preclinical development and first-in-human intra-articular validation as therapeutics for knee osteoarthritis. J Nanobiotechnology. 2025;23:13. DOI:10.1186/s12951-024-03088-x
21. Yamagami R, Kasai T, Ishikura H, Hatano M, Higuchi J, Yoshida S, et al. Baseline magnetic resonance imaging findings associated with short-term clinical outcomes after intraarticular administration of autologous adipose-derived stem cells for knee osteoarthritis. Regener Ther. 2025;28:227-234. DOI:10.1016/j.reth.2024.12.012
22. Spasovski D, Bascarevic Z, Stojiljkovic M, Andjelkovic M, Pavlovic S. Seven-year longitudinal study: clinical evaluation of knee osteoarthritic patients treated with mesenchymal stem cells. J Clin Med. 2024;13(13):3861. DOI:10.3390/jcm13133861
23. Islam MS, Al Mahtab M, Shirian S, Aghayan HR, Arjmand B, Allahverdi A, et al. Encapsulation of rat bone marrow-derived mesenchymal stem cells in collagen type I containing platelet-rich plasma for osteoarthritis treatment in rat model. Prog Biomater. 2022;11(4). DOI:10.1007/s40204-022-00200-y.
24. Chang YH, Wang KC, Chen DC. Enhancing the therapeutic potential of human umbilical cord mesenchymal stem cells for osteoarthritis: the role of platelet-rich plasma and extracellular vesicles. Int J Mol Sci. 2025;26(8):3785: DOI: 10.3390/ijms26083785.
25. Bergström A, Roepstorff L, Alipour MJ, Pettersson K, Ljungvall I. Long-term effect of intra-articular adipose-derived stromal vascular fraction and platelet-rich plasma in dogs with elbow joint disease: a pilot study. Vet Sci. 2024; 11(7):296. DOI:10.3390/vetsci11070296.
26. Pumberger P, Weninger G, Schwaiger K, Zimmermann V. The use of stromal vascular fraction, platelet-rich plasma, and stem cells in the treatment of thumb carpometacarpal osteoarthritis. Plast Reconstr Surg Glob Open. 2025; 13(2): e6481. DOI:10.1097/GOX.0000000000006481
27. Lamo-Espinosa JM, Núñez-Córdoba JM, Blanco JF, Sánchez M, Moreno V, Cabrera M, et al. Effect of hyaluronic acid compared to platelet-rich plasma as adjuvants to bone marrow mesenchymal stem cell treatment of knee osteoarthritis: analysis from two clinical trials. Diagnostics. 2025; 15(3), 309. DOI:10.3390/diagnostics15030309
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Thị Hiền Lê, Lê Minh Tú Phan (Tác giả)
This work is licensed under a Creative Commons Attribution 4.0 International License.
