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For meta\u2010analysis, data on clinical outcomes were measured using visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and data on cartilage repair were measured using the Whole\u2010Organ Magnetic Resonance Imaging Score (WORMS); data on safety were evaluated by the incidence of adverse events. Two researchers independently read the included literature, extracted data and evaluated the quality, used the Cochrane risk bias assessment tool for bias risk assessment, and used RevMan5.3 software for meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten RCTs involving 818 patients with KOA ranging from I to \u2162 on the Kellgren\u2010Lawrence grading scale were included in this meta\u2010analysis. Meta\u2010analysis results showed that at 12 months, the WOMAC total score (mean difference [MD]\u00a0= \u201310.22, 95% confidence interval [CI]: \u201314.86 to \u20135.59,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001,\n                      <jats:italic>Z<\/jats:italic>\n                      \u00a0= 4.32), VAS score (MD\u00a0= \u20131.31, 95% CI: \u20131.90 to \u20130.73,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001,\n                      <jats:italic>Z<\/jats:italic>\n                      \u00a0= 4.40); and WORMS score (MD\u00a0= \u201326.01, 95% CI: \u201331.88 to \u201320.14,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001,\n                      <jats:italic>Z<\/jats:italic>\n                      \u00a0= 8.69) of the MSCs group all decreased significantly (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) compared with the HA control group and reached the minimal clinically important differences. Furthermore, there was no significant difference in the incidence of adverse events (relative risk\u00a0= 1.54, 95% CI:\u00a00.85\u20132.79,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .16,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0= 0) between the 2 groups (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In terms of efficacy, the clinical effects of intra\u2010articular injection therapy using MSCs for KOA are superior to those of HA, and the cartilage repair effect of MSCs is also markedly better than that of HA. Although the clinical effects varied across time periods, the functional score reached the minimum clinically significant difference at both 6 and 12 months. In terms of safety, adverse reactions mainly manifest as joint pain, swelling, and joint effusion. Both intra\u2010articular injections of MSCs and HA did not result in severe adverse reactions, indicating that MSCs and HA have similar safety profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, meta\u2010analysis of Level I studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.07.027","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T19:22:19Z","timestamp":1723836139000},"page":"318-332","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Mesenchymal Stem Cells Injection Is More Effective Than Hyaluronic Acid Injection in the Treatment of Knee Osteoarthritis With Similar Safety: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"41","author":[{"given":"Wen\u2010shu","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Hospital\u2010Acquired Infection Control The Second Affiliated Hospital of Shandong First Medical University Taian City Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u2010xu","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital Shandong Key Laboratory of Rheumatic Disease and Translational Medicine Jinan City Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua\u2010qiang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital Shandong Key Laboratory of Rheumatic Disease and Translational Medicine Jinan City Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital Shandong Key Laboratory of Rheumatic Disease and Translational Medicine Jinan City Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin\u2010feng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital Shandong Key Laboratory of Rheumatic Disease and Translational Medicine Jinan City Shandong Province 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