Efficacy of mesenchymal stem cells in healing of meniscus tear

Background: The meniscus is a semilunar fibro-cartilaginous tissue performing various function including knee joint stability, shock absorption, load distribution, joint lubrication, and joint congruity. Menisectomy often leads to articular cartilage degeneration and ends up in osteoarthritis of knee. Authors described use of mesenchymal stem cells for evaluation of healing of meniscus tear. Purpose: To evaluate the efficacy of mesenchymal stem cells in healing of meniscal tear. Study design: Prospective, randomised, case-control double blinded study. Methods: A total number of 30 patients with meniscus tear of knee, were selected on the basis of predefined inclusion and exclusion criteria after informed written consent. Both cases and controls were 15 in numbers. No case were lost to followup. MRI was done twice pre and post intervention. In case group autologus bone marrow was aspirated, cultured and injected percutaneously under ultrasound guidance. Whereas in control group normal saline was injected as placebo. All patients received standard physiotherapy. Objective assessment was done by functional scoring systems (WOMAC, KOOS, VAS SCORE) Results: There was significant reduction in pain scores (VAS scores) in case group (p=.001) as compared to control group (p=.166).There was improvement in functional outcome scores such as WOMAC in case group (P=.001) as compared to control group (p=.419) and Global KOOS score in case group (p=.001) compared to control group (p=.910). Significant improvement was noted in MRI signals in case group as compared to control group (p=.013) depicting healing of meniscal tears with injection of mesenchymal stem cells. Conclusions: Mesenchymal stem cells injection is efficacious for healing of meniscal tear which reduces pain, helps in integration of torn meniscus and improves functional outcome.