Influence of Synovial Fluid Biochemical Markers on Clinical Outcomes Following Arthroscopic and Non-Arthroscopic Patients with Knee Osteoarthritis.

BACKGROUND

Osteoarthritis (OA) is a degenerative joint disorder that causes pain, stiffness, and functional impairment. Conventional treatments relieve symptoms but do not restore cartilage, limiting long-term efficacy. Cell-based therapies, including mesenchymal stem cells (MSCs) and MSC-derived secretome, have emerged as promising strategies for cartilage regeneration.

OBJECT: This study aimed to assess the therapeutic effects of UC-MSCs and UC-MSC-derived secretome in OA patients through both clinical outcomes and synovial fluid (SF) analyses.

METHODS

Eligible participants were divided into two groups; group who underwent arthroscopy and group who did not. All the participants received an intra-articular injection consisting of an initial 2 mL dose of UC-MSC secretome, followed by 10 million UC-MSCs, and two additional 2 mL doses of secretome administered biweekly. Synovial fluid samples were collected at baseline and 12 weeks post-treatment, centrifuged to obtain the supernatant, and analyzed for inflammatory cytokines and matrix-degrading markers using multiplex and ELISA assays. Clinical evaluations were conducted at 6- and 12-months post-treatment.

RESULT: The results showed that UC-MSC therapy significantly improved functional outcomes in patients with knee osteoarthritis, as indicated by WOMAC scores up to six months. In vitro studies showed similar results, where co-culture of osteoarthritic synovial fluid-derived MSCs with UC-MSCs or UC-MSC secretome enhanced proliferation and differentiation while rapidly reducing pro-inflammatory cytokines (IL-1β, IFN-γ, IL-6, IL-12p70, IL-17A, IL-18) and MMPs (MMP1, MMP7, MMP13).

CONCLUSION

Our findings support a two-stage therapeutic strategy in which UC-MSC secretome first alleviates inflammation, followed by UC-MSCs to promote cartilage regeneration. Post-injection rehabilitation or repeated MSC dosing may further enhance treatment efficacy, highlighting the potential of MSC-based therapies for knee OA management.