Current perspectives on regenerative medicine in early osteoarthritis

Osteoarthritis (OA) is a condition with an enormous economic and social burden. Recent developments in the regenerative medicine field appear to be very promising thanks to the introduction and diffusion of new joint preserving strategies. Among these, the injections of mesenchymal stem cells (i.e., adipose-derived, or bone marrow-derived), and platelet-rich plasma (PRP) are those with the greater interest thanks to their biological bases and easy application. The interest in both adipose-derived and bone marrow-derived stem cells is due to their demonstrated ability to modulate the inflammatory response in vivo, and therefore improve the symptomatology, and the possibility of differentiation into chondrocytes. PRP has shown to provide a significant short-term pain-reducing effect that could be exploited in association with other conservative methodologies. For both methods, the best results might be observed in patients with moderate osteoarthritis but there is evidence to suggest that patients with advanced OA may also benefit from this treatment delaying surgery for joint replacement. However, there are several concerns regarding the best way of use the means of regenerative medicine in OA, as well as to their real effectiveness. In this review we summarized the available concepts in biological bases and clinical outcomes of regenerative medicine in OA. The future increase of evidence may lead to standardization of patient selection criteria to maximize the outcomes.