Mesenchymal or Maintenance Stem Cell & Understanding their Role in Osteoarthritis of the Knee Joint: A Review Article

Mesenchymal Stem Cell (MSC) therapy in osteoarthritis has been hailed as a promising treatment for osteoarthritis dueto their unlimited potential of healing and regeneration. Existing literature regarding their proper name, optimal sources,mechanisms of action, dosage, and route of administration, efficacy, and safety is debatable. This index review articlehas tried to connect these puzzling pieces of available information and brought clarity on some of these crucial issues.The author believes that Maintenance Stem Cells (MSC) may be a more suitable term than mesenchymal stem cell ormedicinal signaling cells as their origin might not be limited to mesodermal tissue. Also, they have been shown capableof self-renewal, differentiation, and maintaining a cascade of healing & possibly regeneration at the implanted site. Onlya small percentage of implanted MSC survive and rest undergo apoptosis after releasing growth factors, cytokines, andextracellular vesicles. These surviving MSC become active due to conformational changes induced by anti-environmentstimuli and undergo limited self-renewal, proliferation, and differentiation, but only a few of them might incorporate into thehost tissues. These cells generate & maintain a momentum of series of regenerative activities to improve the function ofjoint, stabilize or possibly enhance the cartilage quality. More randomized studies with long term follow-up are required tobring clarity on their ideal source, expansion, culture technique, optimum dosage, and route of administration and longtermsafety issues.Level of evidence: V