Is stem cell therapy effective in treating hip osteoarthritis (degenerative joint disease)?

From the Guidelines

Stem cell therapy is not recommended for the treatment of hip osteoarthritis due to insufficient evidence of its effectiveness and potential risks. The most recent and highest quality study, published in 2021 in the Mayo Clinic Proceedings 1, suggests that there is insufficient evidence to support the use of stem cell injections in the treatment of hip and knee OA. Another study published in 2020 in Arthritis Care & Research 1 also strongly recommends against stem cell injections in patients with knee and/or hip OA due to concerns regarding the heterogeneity and lack of standardization in available preparations of stem cell injections, as well as techniques used.

Key Points to Consider

• The current evidence on stem cell therapy for hip osteoarthritis is mixed and inconsistent, with some studies showing modest improvements in pain and function, but results are often temporary and do not reverse structural joint damage 1.
• The biological mechanism of stem cell therapy involves potential anti-inflammatory effects and possible cartilage repair stimulation, but complete regeneration has not been consistently demonstrated.
• Insurance rarely covers stem cell therapy, and out-of-pocket costs can range from $2,000-$10,000 per treatment.
• Patients should consider proven treatments like physical therapy, weight management, and appropriate pain medication as the primary approach for managing hip osteoarthritis, rather than relying on stem cell therapy as a definitive solution.

Recommendations for Clinical Practice

• Do not use stem cell therapy as a primary treatment for hip osteoarthritis due to the lack of strong evidence supporting its effectiveness and potential risks.
• Consider stem cell therapy as a complementary approach only if patients have failed to respond to other proven treatments and are willing to accept the potential risks and costs.
• Emphasize the importance of evidence-based treatments, such as physical therapy, weight management, and appropriate pain medication, in the management of hip osteoarthritis.

From the Research

Efficacy of Stem Cell Therapy in Hip Osteoarthritis

• Stem cell therapy has been proposed as a treatment option for hip osteoarthritis, with several studies investigating its efficacy 2, 3, 4.
• A scoping review of seven studies found that bone marrow-derived stem cell (BM-MSC) therapy alone appeared to be beneficial in improving clinical outcomes in patients with hip osteoarthritis, with reductions in pain and improvements in functional ability 2.
• A study of 10 patients with hip osteoarthritis found that intra-articular injection of autologous BM-MSCs was safe and clinically effective in restoring hip function and range of motion 3.
• A systematic review of 61 studies found that mesenchymal stem cell therapy had a positive effect on osteoarthritis patients, but noted limited high-quality evidence and long-term follow-up 5.
• A narrative review of six studies found that mesenchymal stem cell injections for hip osteoarthritis were safe and provided a positive clinical response, with statistically significant improvements in patient-reported outcomes in five of the six studies 4.

Limitations and Future Directions

• The current evidence is limited by the small number of studies, variable methodologies, and lack of high-quality evidence 2, 5, 4.
• Further high-quality research is needed to establish the clinical and cost-effectiveness of stem cell therapy for hip osteoarthritis, including randomized controlled trials and long-term follow-up 2, 5, 4.
• The optimal preparation and dosage of stem cells for hip osteoarthritis treatment are unclear and require further investigation 2, 5.