Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Metzger, Jay

Keywords

Arthropathy, Mesenchymal Stem Cells, Regenerative Medicine

Abstract

It is estimated that 27% of adults over 45 years of age suffer from osteoarthritis of the hip secondary to articular cartilage damage over the lifespan. Joint pain diminishes life quality, limits range of motion and overall activity, and frequently impairs basic ambulation. These functional deficits worsen the progression of comorbidities that are often referred to as lifestylerelated chronic disease as physical activity subsequently declines. This literature review explores the efficacy of minimally invasive therapies that precede and delay surgical intervention in adult patients experiencing functional limitations and pain in major joints. The study examines the effectiveness of various interventions, including physical therapy, corticosteroid injection, hyaluronic acid injection, platelet-rich plasma injection, and mesenchymal stem cell (MSC) injection. A comprehensive search of PubMed utilizing MeSH terms yielded 114 relevant studies, which were screened based on inclusion criteria. Keywords such as "mesenchymal stem cells," "arthroplasty," and "joints" were used in the search process. While the review reveals a limited number of studies on MSC therapies with small sample sizes, their proposed mechanism of action remains promising. Low side-effect profiles and evidence of induced regeneration within the joints are encouraging, but studies evaluating their effectiveness compared to other treatments are lacking. Incidentally, findings suggest that corticosteroid injections may accelerate joint disease progression, underscoring the value of alternative treatments such as hyaluronic acid or platelet-rich plasma in the early stages of arthropathy. In conclusion, although MSC therapies lack a robust evidence base, their potential warrants further investigation, while caution is advised regarding the use of corticosteroids in the management of arthropathy.

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