What type of study is this?

This is a In Vitro Study study.

What question did this study set out to answer?

To evaluate the effects of stem cell therapies on clinical outcomes for knee osteoarthritis patients.

March 14, 2026Open Access

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

YYanuarsoGatot Soebroto Army Hospital DDDitta Kalyani DeviIndonesian Pediatric Society KLKeri Lestari

Key Points

To evaluate the effects of stem cell therapies on clinical outcomes for knee osteoarthritis patients.
Divided participants into arthroscopic and non-arthroscopic groups.
Administered intra-articular UC-MSC secretome followed by UC-MSC injections biweekly.
Analyzed synovial fluid for inflammatory cytokines and matrix-degrading markers.
Conducted clinical evaluations at 6- and 12-months post-treatment.
UC-MSC therapy improved functional outcomes in knee osteoarthritis patients as measured by WOMAC scores.
In vitro studies confirmed that UC-MSCs reduced pro-inflammatory cytokines and promoted cell proliferation.

Abstract

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.

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

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