The therapeutic potential of mesenchymal stromal cells and their secretome in sport-related injuries

Nour MOBAYED; Dima Joujeh

doi:10.56782/pps.271

Published : 2025-01-18

Vol. 23 No. 1 (2025)

The therapeutic potential of mesenchymal stromal cells and their secretome in sport-related injuries

Nour MOBAYED

Dima Joujeh

DOI: https://doi.org/10.56782/pps.271

Abstract

As the prevalence of sports-related injuries continues to rise, there is an urgent need for innovative therapeutic strategies that not only expedite recovery but also enhance the quality of healing. The application of mesenchymal stromal cells (MSCs) therapy in the treatment of sports injuries represents a groundbreaking advancement in the field of regenerative medicine. This review aims to summarize and discuss the therapeutic effects of MSCs in facilitating tissue regeneration and expediting the healing process following sports-related injuries. It also aims to highlight current research findings regarding the efficacy, safety and administration routes in clinical MSCs therapy trials. Data was obtained by searching Pubmed and Google Scholar, using the keywords: ‘sport injury, ‘Osteoarthritis’, ‘mesenchymal stromal/stem cells’, ‘tendon’, ‘cartilage defect’, ‘ligament injury’, ‘MSC secretome’, ‘conditioned medium’. According to the U. S. National Library of Medicine, there have been a total of 7,146 registered clinical trials worldwide on stem cell therapy till 5/10/2024, with 1,626 specifically focusing on MSCs therapy. The safety and efficacy of MSCs and MSCs secretome therapies in treating sport-related injuries have been shown in many preclinical studies. The promising outcomes observed in experimental studies have propelled the transition to clinical trials, which have also shown positive results. MSCs therapy has the potential to accelerate healing processes, reduce downtime, and allow athletes to return to their sport faster and with greater confidence. This is crucial not only for professional athletes but also for recreational sports enthusiasts who seek to maintain an active lifestyle. However, bone marrow mesenchymal stromal cells (BM-MSCs), umbilical cord mesenchymal stromal cells (UCB-MSCs) and adipose-derived mesenchymal stromal cells (AD-MSCs) were predominantly utilized in these trials, indicating that there is unexplored therapeutic potential of MSCs from other sources. This review not only aims to contribute valuable knowledge to the field, but also aspires to inspire further exploration and innovation in the use of MSCs for enhancing athletic performance and recovery.

Keywords:

sport injury, mesenchymal stromal cells, cartilage defect, ligament injury, MSCs secretome

Similar Articles

Anna Szymanowska, Agnieszka Gornowicz, Anna Bielawska, Krzysztof Bielawski, PLANT STEM CELLS AND THEIR APPLICATION IN COSMETOLOGY AND REGENERATIVE MEDICINE , Prospects in Pharmaceutical Sciences: Vol. 17 No. 7 (2019)
Aleksandra Grzybowska, Tomasz Lorenc, Wioletta Olejarz, Grażyna Nowicka, EXOSOMES AS CARRIERS OF INFORMATION BEETWEN TUMOR CELLS , Prospects in Pharmaceutical Sciences: Vol. 17 No. 2 (2019)
Mateusz Żaczko, Tomasz Lorenc, Wioletta Olejarz, Grażyna Nowicka, PERSPECTIVES OF THERAPEUTIC USE OF EXOSOMES IN THE MOST COMMON CANCERS , Prospects in Pharmaceutical Sciences: Vol. 17 No. 6 (2019)
Ewelina Flegiel, Magdalena Piotrowska, Magdalena Ptasznik, Aleksandra Baran, Justyna Lenart, Miłosz Podrażka, Joanna Mazurek, Hubert Stachowicz, Weronika Bartos, Monika Adamczyk, Review of the effects of sodium butyrate on obesity, inflammatory bowel disease, pregnancy and colorectal cancer , Prospects in Pharmaceutical Sciences: Vol. 22 No. 4 (2024)
Olga Ciepiela, Patrycja Dąbrowska, Helena Donica, A. Goliszek, Ireneusz P. Grudziński, J. Jedlińska, Maciej Korpysz, Paweł Kozłowski, Natalia Krześniak, Kamila Marciniec, D. Mika, K. Ołownia, Aleksandra Ozygała, Monika Paskudzka, J. Rachuna, Klaudia Radoszkiewicz, K. Rozmianiec, Mariusz Rozwandowicz, Anna Sarnowska, D. Sitarz, K. Szafraniec, Magdalena Szymańska, Monika Szymoniak, Marcin Śmiarowski, WARSZAWSKA JESIEŃ DIAGNOSTYCZNA , Prospects in Pharmaceutical Sciences: Vol. 21 No. S1 (2023): Konferencja naukowo-szkoleniowa Warszawska Jesień Diagnostyczna 28.09.-29.09.2023
Marta Kuśnierek, Monika Czerwińska, Lycium barbarum polysaccharide fraction – isolation from fruits and impact on the secretion of inflammatory mediators by human mononuclear cells and neutrophils , Prospects in Pharmaceutical Sciences: Vol. 22 No. 4 (2024)
Katarzyna Herjan, Piotr Armański, Jakub Olszewski, Magdalena Sitnik, Maciej Bara, Positive impact of tranexamic acid in various medical settings , Prospects in Pharmaceutical Sciences: Vol. 22 No. 3 (2024)
Uzma Faridi, Anti-cancer activity of phenyl-1,3,5-heptatriyne in human liver cancer , Prospects in Pharmaceutical Sciences: Vol. 22 No. 4 (2024)
Arkadiusz Kocur, Dorota Marszałek, Tomasz Pawiński, USE OF CHROMATOGRAPHIC METHODS FOR INOSINE DEHYDROGENASE ACTIVITY DETERMINATION (IMPDH) IN IMMUNOSUPPRESSIVE THERAPY , Prospects in Pharmaceutical Sciences: Vol. 18 No. 5 (2020)
Anna Król, THE ROLE OF IMMUNE CELLS IN THE PATHOGENESIS OF GRAVES' ORBITOPATHY , Prospects in Pharmaceutical Sciences: Vol. 17 No. 3 (2019)

1 2 > >>

You may also start an advanced similarity search for this article.

Details

References

Statistics

Authors

Download files

PDF

Citation rules

MOBAYED, N., & Joujeh, D. (2025). The therapeutic potential of mesenchymal stromal cells and their secretome in sport-related injuries. Prospects in Pharmaceutical Sciences, 23(1), 9–24. https://doi.org/10.56782/pps.271

Altmetric indicators

Cited by / Share

Licence

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

1. Elmagd, M. A. Common sports injuries. Int. J. Phys. Educ. Sports Health. 2016, 3 (5), 142-148.

2. Rahim, S.; Rahim, F.; Shirbandi, K.; Haghighi, B. B.; Arjmand, B. Sports Injuries: Diagnosis Prevention Stem Cell Therapy and Medical Sport Strategy. Tissue Eng. Regen. Med. 2018, 1084, 129–144. DOI: 10.1007/5584_2018_298

3. Finnoff, J.; Awan, T.; Borg-Stein, J.; Harmon, K.; Herman, D.; Malanga, G.; Master, Z.; Mautner, K.; Shapiro, S. American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine. Clin. J. Sport Med. 2021, 31 (6), 530-541. DOI: 10.1097/JSM.0000000000000973

4. Moradi, S. Z.; Jalili, F.; Hoseinkhani, Z.; Mansouri, K. Regenerative Medicine and Angiogenesis; Focused on Cardiovascular Disease. Adv. Pharm. Bull. 2022, 12 (4), 686-699. DOI: 10.34172/apb.2022.072

5. Trohatou, O.; Roubelakis, M. G. Mesenchymal Stem/Stromal Cells in Regenerative Medicine: Past Present and Future. Cell Reprogram. 2017, 19 (4), 217-224. DOI: 10.1089/cell.2016.0062

6. Ángel, M. G.; Pedroza-Gonzalez, A.; Romo, G.; Stella, G.; Alvarez, M.; Olimpia, K.; Aparicio, H.; Aram, A. Advances in the Therapeutic Use of Mesenchymal Stromal Cells in Regenerative Medicine. Int. J. Educ. & Sci. Methods 2023, 11 (9), 542-549.

7. Yu, H.; Habibi, M.; Motamedi, K.; Semirumi, D. T.; Ghorbani, A. Utilizing stem cells in reconstructive treatments for sports injuries: An innovative approach. Tissue Cell. 2023, 83, Art. No: 102152. DOI: 10.1016/j.tice.2023.102152

8. Zumwalt, M.; Reddy, A. P. Stem Cells for Treatment of Musculoskeletal Conditions - Orthopaedic/Sports Medicine Applications. BBA - Mol. Basis Dis. 2020, 1866 (4), Art. No: 165624. DOI: 10.1016/j.bbadis.2019.165624

9. Ning, C.; Li, M.; Ge, L. The preventive effect of PNF stretching exercise on sports injuries in physical education based on IoT data monitoring. Prev. Med. 2023, 173, Art. No: 107591. DOI: 10.1016/j.ypmed.2023.107591

10. Cui, J.; Du, H.; Wu, X. Data analysis of physical recovery and injury prevention in sports teaching based on wearable devices. Prev. Med. 2023, 173, Art. No: 107589. DOI: 10.1016/j.ypmed.2023.107589

11. Kwon, J.; Jang, J. Factors Influencing Injury Severity and Frequency among Korean Sports Participants in Their 20s and 30s. Healthcare 2024, 12, Art. No: 664. DOI: 10.3390/healthcare12060664

12. Trebinjac, S.; Gharairi, M. Mesenchymal Stem Cells for Treatment of Tendon and Ligament Injuries-Clinical Evidence. Med. Arch. 2020, 74 (5), 387-390. DOI: 10.5455/medarh.2020.74.387-390

13. Liu, H.; Ding, H.; Xuan, J.; Gao, X.; Huang, X. The functional movement screen predicts sports injuries in Chinese college students at different levels of physical activity and sports performance. Heliyon 2023, 9 (6), Art. No: e16454. DOI: 10.1016/j.heliyon.2023.e16454

14. Sommerfield, L. M.; Harrison, C. B.; Whatman, C. S.; Maulder, P. S. A prospective study of sport injuries in youth females. Phys. Ther. Sport. 2020, 44, 24-32. DOI: 10.1016/j.ptsp.2020.04.005

15. Sharma, S.; Killedar, R.; Bagewadi, D.; Shindhe, P. Protocol based management of common sports injuries by integrated approach of Sandhi Marmabhighata - An open labeled clinical trial. J. Ayurveda Integr. Med. 2021, 12 (1), 119-125. DOI: 10.1016/j.jaim.2020.12.009

16. Beelen, P. E.; van Dieën, J. H.; Prins, M. R.; Nolte, P. A.; Kingma, I. The effect of cryotherapy on postural stabilization assessed by standardized horizontal perturbations of a movable platform. Gait Posture 2022, 94, 32-38. DOI: 10.1016/j.gaitpost.2022.02.022

17. Pannone, E.; Abbott, R. What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultra-endurance running: a scoping review. BMJ Open Sport Exerc. Med. 2024, 10, Art. No: e001846. DOI: 10.1136/bmjsem-2023-001846

18. Vaish, A.; Vaishya, R. Stem cells in orthopaedics and sports injuries: A comprehensive review and future research directions. J. Orthop. Case Rep. 2024, 3 (4), Art. No: 100344. DOI: 10.1016/j.jorep.2024.100344

19. Costa, J. B.; Pereira, H.; Espregueira-Mendes, J.; Khang, G.; Oliveira, J. M.; Reis, R. L. Tissue engineering in orthopaedic sports medicine: current concepts. J. ISAKOS. 2017, 2 (2), 60-66. DOI: 10.1136/jisakos-2016-000080

20. Adel, M.; Keyhanvar, P.; Zare, I.; Tavangari, Z.; Akbarzadeh, A.; Zahmatkeshan, M. Nanodiamonds for tissue engineering and regeneration. J. Drug Deliv. Sci. Technol. 2023, 90, Art. No: 105130. DOI: 10.1016/j.jddst.2023.105130

21. Sharma, P.; Kumar, P.; Sharma, R.; Bhatt, V. D.; Dhot, P. S. Tissue Engineering; Current Status & Futuristic Scope. J. Med. Life 2019, 12 (3), 225-229. DOI: 10.25122/jml-2019-0032

22. Pasculli, R. M.; Kenyon, C. D.; Berrigan, W. A.; Mautner, K.; Hammond, K.; Jayaram, P. Mesenchymal stem cells for subchondral bone marrow lesions: From bench to bedside. Bone Rep. 2022, 17, Art. No: 101630. DOI: 10.1016/j.bonr.2022.101630

23. Viganò, M.; Sansone, V.; d’Agostino, M. C.; Romeo, P.; Orfei, C. P.; Girolamo, L. D. Mesenchymal stem cells as therapeutic target of biophysical stimulation for the treatment of musculoskeletal disorders. J. Orthop. Surg. Res. 2016, 11, Art. No: 163. DOI: 10.1186/s13018-016-0496-5

24. Joujeh, D.; Ghrewaty, A.; Soukkarieh, C.; Almarrawi, A. An optimized protocol for mouse bone marrow mesenchymal stromal cells isolation and culture. Cell Ther. Transplant. 2021, 10 (3-4), 61-70. DOI: 10.18620/ctt-1866-8836-2021-10-3-4-61-70

25. Kouchakian, M. R.; Baghban, N.; Moniri, S. F.; Baghban, M.; Bakhshalizadeh, S.; Najafzadeh, V.; Safaei, Z.; Izanlou, S.; Khoradmehr, A.; Nabipour, I.; Shirazi, R. The Clinical Trials of Mesenchymal Stromal Cells Therapy. Stem Cells Int. 2021, 3, Art. No: 1634782. DOI: 10.1155/2021/1634782

26. Choudhery, M.S.; Mahmood, R.; Harris, D.T.; Ahmad, F.J. Minimum criteria for defining induced mesenchymal stem cells. Cell Biol. Int. 2022, 46(6), 986-989. doi: 10.1002/cbin.11790

27. Malekpour, K.; Hazrati, A.; Zahar, M.; Markov, A.; Zekiy, A. O.; Navashenaq, G.; Roshangar, L.; Ahmadi, M. The Potential Use of Mesenchymal Stem Cells and Their Derived Exosomes for Orthopedic Diseases Treatment. Stem Cell Rev. Rep. 2022, 18, 933–951. DOI: 10.1007/s12015-021-10185-z

28. Bhat, S.; Viswanathan, P.; Chandanala, S.; Prasanna, S. J.; Seetharam, R. N. Expansion and characterization of bone marrow derived human mesenchymal stromal cells in serum-free conditions. Sci. Rep. 2021, 11 (1), Art. No: 3403. DOI: 10.1038/s41598-021-83088-1

29. Li, X.; Guan, Y.; Li, C.; Zhang, T.; Meng, F.; Zhang, J.; Li, J.; Chen, S.; Wang, Q.; Wang, Y.; Peng, J.; Tang, J. Immunomodulatory effects of mesenchymal stem cells in peripheral nerve injury. Stem Cell Res. Ther. 2022, 13(1), Art. No: 18. DOI: 10.1186/s13287-021-02690-2

30. Mannino, G.; Russo, C.; Longo, A.; Anfuso, C. D.; Lupo, G.; Furno, D. L.; Giuffrida, R.; Giurdanella, G. Potential therapeutic applications of mesenchymal stem cells for the treatment of eye diseases. World J. Stem Cells. 2021, 13 (6), 632-644. DOI: 10.4252/wjsc. v13.i6.632

31. Bruna, F.; Contador, D.; Conget, P.; Erranz, B.; Sossa, C. L.; Arango-Rodríguez, M. L. Regenerative Potential of Mesenchymal Stromal Cells: Age-Related Changes. Stem Cells Int. 2016, 2016, Art. No: 1461648. DOI: 10.1155/2016/1461648

32. Joujeh, D.; Ghrewaty, J.; Almarrawi, A.; Soukkarieh, C.; Darwicha, J. A. Therapeutic potential of conditioned medium derived from bone marrow mesenchymal stromal cells cocultured with hepatocytes in alleviation of CCl4-induced liver damage in mice. Cell Ther. Transplant. 2022, 11 (2), 84-92. DOI: 10.18620/ctt-1866-8836-2022-11-2-84-92

33. Mabotuwana, S.; Rech, L.; Lim, J.; Hardy, J.; Murtha, L.; Peter, P.; Rainer, P.; Boyle, A. Paracrine Factors Released by Stem Cells of Mesenchymal Origin and their Effects in Cardiovascular Disease: A Systematic Review of Pre-Clinical Studies. Stem Cell Rev. Rep. 2022, 18, 2606–2628. DOI: 10.1007/s12015-022-10429-6

34. Sandonà, M.; Pietro, L. D.; Esposito, F.; Ventura, A.; Silini, A. R.; Parolini, O.; Saccone, V. Mesenchymal Stromal Cells and Their Secretome: New Therapeutic Perspectives for Skeletal Muscle Regeneration. Front. Bioeng. Biotechnol. 2021, 9, Art. No: 652970. DOI: 10.3389/fbioe.2021.652970

35. Giacomini, C.; Granéli, C.; Hicks, R.; Dazzi, F. The critical role of apoptosis in mesenchymal stromal cell therapeutics and implications in homeostasis and normal tissue repair. Cell. Mol. Immunol. 2023, 20, 570–582. DOI:10.1038/s41423-023-01018-9

36. Kurte M.; Vega-Letter A.M.; Luz-Crawford P.; Djouad F.; Noël D.; Khoury M.; Carrión F.Time-dependent LPS exposure commands MSC immunoplasticity through TLR4 activation leading to opposite therapeutic outcome in EAE. Stem Cell Res. Ther. 2020, 11, Art. No: 416. DOI: 10.1186/s13287-020-01840-2

37. Gao F.; Chiu S.; Motan D.; Zhang Z.; Chen L.; Ji H.; Fu Q.; Lian Q. Mesenchymal stem cells and immunomodulation: current status and future prospects. Cell Death Dis. 2016, 7, Art. No: e2062. DOI: 10.1038/cddis.2015.327

38. Hladkykh, F. Mesenchymal Stem Cells: Exosomes and Conditioned Media as Innovative Strategies in the Treatment of Patients with Autoimmune Diseases. Biomed. Res. Int. 2023, 6, 121-130. DOI: 10.31612/2616-4868.6.2023.15

39. Zeng, Q. L.; Liu, D. W. Mesenchymal stem cell-derived exosomes: An emerging therapeutic strategy for normal and chronic wound healing. World J. Clin. Cases 2021, 9 (22), 6218-6233. DOI: 10.12998/wjcc. v9. i22.6218

40. Tan, X.; Xiao, H.; Yan, A.; Li, M.; Wang, L. Effect of Exosomes from Bone Marrow–Derived Mesenchymal Stromal Cells and Adipose-Derived Stromal Cells on Bone-Tendon Healing in a Murine Rotator Cuff Injury Model. Orthop. J. Sports Med. 2024, 12 (1), Art. No: 23259671231210304. DOI: 10.1177/23259671231210304

41. Smolinská, V.; Bohac, M.; Danišovič, L. Current Status of the Applications of Conditioned Media Derived from Mesenchymal Stem Cells for Regenerative Medicine. Physiol. Res. 2023, 72 (S3), S233-S245. DOI: 10.33549/physiolres.935186

42. Szabłowska-Gadomska, I.; Rudzinski, S.; Dymowska, M. Secretome of Mesenchymal Stromal Cells as a Possible Innovative Therapeutic Tool in Facial Nerve Injury Treatment. Biomed. Res. Int. 2023, 2, 1-7. DOI: 10.1155/2023/8427200

43. Teixeira, F.; Salgado, A. Mesenchymal stem cells secretome: current trends and future challenges. Neural Regen. Res. 2020, 15 (1), 75-77. DOI: 10.4103/1673-5374.264455

44. Sandonà, M.; Di Pietro, L.; Esposito, F.; Ventura, A.; Silini, A. R.; Parolini, O.; & Saccone, V. Mesenchymal stromal cells and their secretome: new therapeutic perspectives for skeletal muscle regeneration. Front. Bioeng. Biotechnol. 2021, 9, Art. No: 652970. DOI: 10.3389/fbioe.2021.652970

45. Li, Q.; Zhang, F.; Fu, X.; & Han, N. Therapeutic potential of mesenchymal stem cell-derived exosomes as nanomedicine for peripheral nerve injury. Int. J. Mol. Sci. 2024, 25(14), Art. No: 7882. Doi.org/10.3390/ijms25147882.

46. Welsh, J. A.; Goberdhan, D. C.; O'Driscoll, L.; Buzas, E. I.; Blenkiron, C.; Bussolati, B.; et al. Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches. J. Extracell. Vesicles 2024, 13(2), Art. No: e12404. Doi: 10.1002/jev2.12404.

47. Khan, T.; Khan, T.; Khan, W. S.; Malik, A. A. Clinical Application of Stem Cells to Include Muscle Bone and Tendon Pathology. Bone Cartilage Regen. 2017, 2, 77–87. DOI: 10.1007/978-3-319-40144-7_4

48. von Roth, P.; Duda, G.; Radojewski, P.; Preininger, B.; Perka, C.; Winkler, T. Mesenchymal Stem Cell Therapy Following Muscle Trauma Leads to Improved Muscular Regeneration in Both Male and Female Rats. Gender Med. 2012, 9 (2), 129-136. DOI: 10.1016/j.genm.2012.01.007

49. Quertainmont, R.; Cantinieaux, D.; Botman, O.; Sid, S.; Schoenen, J.; Franzen, R. Mesenchymal Stem Cell Graft Improves Recovery after Spinal Cord Injury in Adult Rats through Neurotrophic and Pro-Angiogenic Actions. PLoS ONE 2012, 7 (6), Art. No: e39500. DOI: 10.1371/journal.pone.0039500

50. Matthes, S.; Reimers, K.; Janssen, I.; Liebsch, C.; Kocsis, J.; Vogt, P.; Radtke, C. Intravenous Transplantation of Mesenchymal Stromal Cells to Enhance Peripheral Nerve Regeneration. Biomed. Res. Int. 2013, 2013, Art. No: 573169. DOI: 10.1155/2013/573169

51. von Roth, P.; Winkler, T.; Rechenbach, K.; Radojewski, P.; Perka, C.; Duda, G. N. Improvement of Contraction Force in Injured Skeletal Muscle after Autologous Mesenchymal Stroma Cell Transplantation Is Accompanied by Slow to Fast Fiber Type Shift. Transfus. Med. Hemother. 2013, 40 (6), 425–430. DOI: 10.1159/000354127

52. Kamel, N. S.; Arafa, M. M.; Nadim, A.; Amer, A.; Amin, I. R.; Samir, N.; Salem, A. Effect of intra-articular injection of mesenchymal stem cells in cartilage repair in experimental animals. Egyptian Rheumatologist 2014, 36 (4), 179-186. DOI: 10.1016/j.ejr.2014.03.001

53. Lee, S. Y.; Kim, W.; Lim, C.; Chung, S. G. Treatment of Lateral Epicondylosis by Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study. Stem Cells 2015, 33 (10), 2995–3005. DOI: 10.1002/stem.2110

54. Chamberlain, C. S.; Saether, E. E.; Aktas, E.; Vanderby, R. Mesenchymal Stem Cell Therapy on Tendon/Ligament Healing. J. Cytokine Biol. 2017, 2 (1), Art. No: 112. DOI: 10.4172/2576-3881.1000112

55. Brickson, S.; Meyer, P.; Saether, E.; Vanderby, R. Mesenchymal Stem Cells Improve Muscle Function Following Single Stretch Injury: A Preliminary Study. J. Funct. Morphol. Kinesiol. 2016, 1 (4), 396-406. DOI: 10.3390/jfmk1040396

56. Feng, C.; Luo, X.; He, N.; Xia, H.; Lv, X.; Zhang, X.; Li, D.; Wang, F.; He, J.; Zhang, L.; Lin, X.; Lin, L.; Yin, H.; He, J.; Wang, J.; Cao, W.; Wang, R.; Zhou, G.; Wang, W. Efficacy and Persistence of Allogeneic Adipose-Derived Mesenchymal Stem Cells Combined with Hyaluronic Acid in Osteoarthritis After Intra-Articular Injection in a Sheep Model. Tissue Eng. Part A. 2018, 24 (3-4), 219-233. DOI: 10.1089/ten.tea.2017.0039

57. Jo, C. H.; Won, Chai, J.; Jeong, E. C.; Oh, S.; Kim, P. S.; Yoon, J. Y.; Yoon, K. S. Intratendinous Injection of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells for the Treatment of Rotator Cuff Disease: A First-In-Human Trial. Stem Cells 2018, 36 (9), 1441–1450. DOI: 10.1002/stem.2855

58. Lee, Y. C.; Chan, Y. H.; Hsieh, S. C.; Lew, W. Z.; Feng, S. W. Comparing the Osteogenic Potentials and Bone Regeneration Capacities of Bone Marrow and Dental Pulp Mesenchymal Stem Cells in a Rabbit Calvarial Bone Defect Model. Int. J. Mol. Sci. 2019, 20 (20), Art. No: 5015. DOI: 10.3390/ijms20205015

59. Khoury, M.; Tabben, M.; Rolón, A. U.; Levi, L.; Chamari, K.; D’Hooghe, P. Promising improvement of chronic lateral elbow tendinopathy by using adipose derived mesenchymal stromal cells: a pilot study. J. Exp. Orthop. 2021, 8(1), Art. No: 6. DOI: 10.1186/s40634-020-00320-z

60. Chang, Y.; Ding, D.; Wu, K. Human Umbilical Mesenchymal Stromal Cells Mixed with Hyaluronan Transplantation Decreased Cartilage Destruction in a Rabbit Osteoarthritis Model. Stem Cells Int. 2021, 2021, Art. No: 2989054. DOI: 10.1155/2021/2989054

61. Boulos, A. N.; El-Agawany, A. M.; Awwad, A. E.; Fouad, G. M.; Abd El-Rahman, A. G. The Effect of Bone Marrow Mesenchymal Stem Cells on Experimentally-Induced Gastrocnemius Muscle Injury in Female Albino Rats. Egypt. J. Histol. 2021, 44 (1), 218-235. DOI: 10.21608/ejh.2020.24878.1257

62. Hirota, R.; Sasaki, M.; Kataoka-Sasaki, Y.; Oshigiri, T.; Kurihara, K.; Fukushi, R.; Oka, S.; Ukai, R.; Yoshimoto, M.; Kocsis, J. D.; Yamashita, T.; Honmou, O. Enhanced Network in Corticospinal Tracts after Infused Mesenchymal Stem Cells in Spinal Cord Injury. J. Neurotrauma 2022, 39 (23-24), 1665-1677. DOI: 10.1089/neu.2022.0106

63. Shosha, A. I.; Tawfik, S. M.; Laag, E. M.; Elshal, A. O. Histological Study of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Experimentally Induced Skeletal Muscle Injury in Adult Male Albino Rats. Egypt. J. Histol. 2023, 46(3), 1483-1493. DOI: 10.21608/EJH.2022.139384.1688

64. Chen, J.; Zhu, Y.; Gao, H.; Chen, X.; Yi, D.; Li, M.; Wang, L.; Xing, G.; Chen, S.; Tang, J.; Wang, Y. HucMSCs Delay Muscle Atrophy After Peripheral Nerve Injury Through Exosomes by Repressing Muscle-Specific Ubiquitin Ligases. Stem Cells 2024, 42(5), 460–474. DOI: 10.1093/stmcls/sxae017

65. Yuan, Z.; Yu, D.; Wang, Y.; Liu, L.; Wang, J.; Ma, C.; Wu, S. Early Delivery of Human Umbilical Cord Mesenchymal Stem Cells Improves Healing in a Rat Model of Achilles Tendinopathy. Regen. Med. 2023, 19(2), 93–102. DOI: 10.2217/rme-2023-0222

66. Chamberlain, C. S.; Prabahar, A.; Kink, J. A.; Mueller, E.; Li, Y.; Yopp, S.; Capitini, C. M.; Hematti, P.; Murphy, W.; Vanderby, R.; Jiang, P. Modulating the Mesenchymal Stromal Cell Microenvironment Alters Exosome RNA Content and Ligament Healing Capacity. Stem Cells 2024, 42(7), 636-649. DOI: 10.1093/stmcls/sxae028

67. Rhatomy, S.; Pawitan, J. A.; Kurniawati, T.; Fiolin, J.; Dilogo, I. H. Allogeneic Umbilical Cord Mesenchymal Stem Cell Conditioned Medium (Secretome) for Treating Posterior Cruciate Ligament Rupture: A Prospective Single-Arm Study. Eur. J. Orthop. Surg. Traumatol. 2023, 33(3), 669-675. DOI: 10.1007/s00590-022-03278-z

68. Cai, J.; Xu, J.; Ye, Z.; Wang, L.; Zheng, T.; Zhang, T.; Li, Y.; Jiang, J.; Zhao, J. Exosomes Derived from Kartogenin-Preconditioned Mesenchymal Stem Cells Promote Cartilage Formation and Collagen Maturation for Enthesis Regeneration in a Rat Model of Chronic Rotator Cuff Tear. Am. J. Sports Med. 2023, 51(5), 1267-1276. DOI: 10.1177/03635465231155927

69. Gionet-Gonzales, M.; Gresham, R.; Griffin, K.; Casella, A.; Wohlgemuth, R.; Ramos-Rodriguez, D.; Lowen, J.; Smith, L. Mesenchymal Stromal Cell Spheroids in Sulfated Alginate Enhance Muscle Regeneration. Acta Biomaterialia 2023, 155(1), 271-281. DOI: 10.1016/j.actbio.2022.10.054

70. Shen, H.; Lane, R. A. Extracellular Vesicles from Primed Adipose-Derived Stem Cells Enhance Achilles Tendon Repair by Reducing Inflammation and Promoting Intrinsic Healing. Stem Cells 2023, 41(6), 617–627. DOI: 10.1093/stmcls/sxad032

71. Zhu, Z.; Gao, R.; Ye, T.; Feng, K.; Zhang, J.; Chen, Y.; Xie, Z.; Wang, Y. The Therapeutic Effect of iMSC-Derived Small Extracellular Vesicles on Tendinopathy Related Pain Through Alleviating Inflammation: An in vivo and in vitro Study. J. Inflamm. Res. 2022, 15, 1421-1436. DOI: 10.2147/JIR.S345517

72. Luo, Z.; Sun, Y.; Qi, B.; Lin, J.; Chen, Y.; Xu, Y.; Chen, J. Human Bone Marrow Mesenchymal Stem Cell-Derived Extracellular Vesicles Inhibit Shoulder Stiffness via let-7a/Tgfbr1 Axis. Bioact. Mater. 2022, 17, 344-359. DOI: 10.1016/j.bioactmat.2022.01.016

73. Wu, X.; Kang, L.; Tian, J.; Wu, Y.; Huang, Y.; Liu, J.; Wang, H.; Qiu, G.; Wu, Z. Exosomes Derived from Magnetically Actuated Bone Mesenchymal Stem Cells Promote Tendon-Bone Healing Through the miR-21-5p/SMAD7 Pathway. Materials Today Bio. 2022, 15, Art. No: 100319. DOI: 10.1016/j.mtbio.2022.100319

74. Zhang, T.; Yan, S.; Song, Y.; Chen, C.; Xu, D.; Lu, B.; Xu, Y. Exosomes Secreted by Hypoxia-Stimulated Bone-Marrow Mesenchymal Stem Cells Promote Grafted Tendon-Bone Tunnel Healing in Rat Anterior Cruciate Ligament Reconstruction Model. J. Orthop. Translat. 2022, 36, 152-163. DOI: 10.1016/j.jot.2022.08.001

75. Hede, K.; Christensen, B.; Olesen, M.; Thomsen, J.; Foldager, C.; Toh, W.; Lim, S.; Lind, M. Mesenchymal Stem Cell Extracellular Vesicles as Adjuvant to Bone Marrow Stimulation in Chondral Defect Repair in a Minipig Model. CARTILAGE 2021, 13(2), 254S-266S. DOI: 10.1177/19476035211029707

76. Huang, Y.; He, B.; Wang, L.; Yuan, B.; Shu, H.; Zhang, F.; Sun, L. Bone marrow mesenchymal stem cell-derived exosomes promote rotator cuff tendon-bone healing by promoting angiogenesis and regulating M1 macrophages in rats. Stem Cell Res. Ther. 2020,11, Art. No: 496. DOI: 10.1186/s13287-020-02005-x

77. Shi, Z.; Wang, Q.; Jiang, D. Extracellular vesicles from bone marrow-derived multipotent mesenchymal stromal cells regulate inflammation and enhance tendon healing. J. Transl. Med. 2019, 17, Art. No: 211. DOI: 10.1186/s12967-019-1960-x

78. Mitchell, R.; Mellows, B.; Sheard, J.; Antonioli, M.; Kretz, O.; Chambers, D.; Zeuner, M.; Tomkins, J. Secretome of adipose-derived mesenchymal stem cells promotes skeletal muscle regeneration through synergistic action of extracellular vesicle cargo and soluble proteins. Stem Cell Res. Ther. 2019, 10, Art. No: 116. DOI: 10.1186/s13287-019-1213-1

79. Kornicka-Garbowska, K.; Pędziwiatr, R.; Woźniak, P.; Kucharczyk, K.; Marycz, K. Microvesicles isolated from 5-azacytidine-and-resveratrol-treated mesenchymal stem cells for the treatment of suspensory ligament injury in horse—a case report. Stem Cell Res. Ther. 2019, 10, Art. No: 394. DOI: 10.1186/s13287-019-1469-5

80. Mao, G.; Zhang, Z.; Hu, S.; Zhang, Z.; Chang, Z.; Huang, Z.; Liao, W.; Kang, Y. Exosomes derived from miR-92a-3p-overexpressing human mesenchymal stem cells enhance chondrogenesis and suppress cartilage degradation via targeting WNT5A. Stem Cell Res. Ther. 2018, 9, Art. No: 247. DOI: 10.1186/s13287-018-1004-0

81. Wang, Y.; Yu, D.; Liu, Z.; Zhou, F.; Dai, J.; Wu, B.; Zhou, J.; Heng, B.; Zou, x.; Ouyang, H.; Liu, H. Exosomes from embryonic mesenchymal stem cells alleviate osteoarthritis through balancing synthesis and degradation of cartilage extracellular matrix. Stem Cell Res. Ther. 2017, 8, Art. No: 189. DOI: 10.1186/s13287-017-0632-0

82. Zhang, S.; Chu, WC.; Lai, RC.; Lim, SK.; Hui, JH.; Toh, WS. Exosomes derived from human embryonic mesenchymal stem cells promote osteochondral regeneration. OARSI 2016, 24(12), P2135-2140. DOI: 10.1016/j.joca.2016.06.022

83. Xu, S.; Liu, H.; Xie, Y.; Sang, L.; Liu, J.; Chen, B. Effect of mesenchymal stromal cells for articular cartilage degeneration treatment: A meta-analysis. Cytotherapy 2015, 17(10), 1342-1352. DOI: 10.1016/j.jcyt.2015.05.005

84. Wang, Y.; Chu, W.; Zhai, J.; Wang, W.; He, Z.; Zhao, Q.; Li, C. High quality repair of osteochondral defects in rats using the extracellular matrix of antler stem cells. World J. Stem Cells 2024, 16(2), 176-190. DOI: 10.4252/wjsc. v16.i2.176

85. Berounský, K.; Vackova, I.; Vištejnová, L.; Malečková, A.; Havránková, J.; Klein, P.; Kolinko, Y.; Petrenko, Y.; Prazak, S.; Hanák, F.; Přidal, J.; Havlas, V. Autologous Mesenchymal Stromal Cells Immobilized in Plasma-Based Hydrogel for the Repair of Articular Cartilage Defects in a Large Animal Model. Physiol. Bohemoslov. 2023, 72(4), 485-495. DOI: 10.33549/physiolres.935098

86. Xu, T.; Yu, X.; Xu, K.; Lin, Y.; Wang, J.; Pan, Z.; Fang, J.; Wang, S.; Zhou, Z, Song, H.; Zhu, S.; Dai, X. Comparison of the ability of exosomes and ectosomes derived from adipose-derived stromal cells to promote cartilage regeneration in a rat osteochondral defect model. Stem Cell Res. 2024, 15(1), Art. No: 18. DOI: 10.1186/s13287-024-03632-4

87. Wen, S.; Huang, X.; Ma, J.; Zhao, G.; Ma, T.; Chen, K.; Huang, G.; Jie, C.; Shi, J.; Wang, S. Exosomes derived from MSC as drug system in osteoarthritis therapy. Front. Biol. 2024, 12, Art. No: 1331218. DOI: 10.3389/fbioe.2024.1331218

88. Amoako, A. O.; Pujalte, G. G. Osteoarthritis in young, active, and athletic individuals. Clin. Med. Insights Arthritis Musculoskelet. Disord. 2014, 7, 27-32. doi: 10.4137/CMAMD.S14386

89. Carbone, A.; Rodeo, S. Review of current understanding of post-traumatic osteoarthritis resulting from sports injuries. J. Orthop. Res. 2016, 35(3), 397-405. DOI: 10.1002/jor.23341

90. Mussin, N.; Tamadon, A.; Kaliyev, A. Unlocking the Potential: The Importance of Mesenchymal Stem Cell Therapy for Knee Osteoarthritis. West Kaz.med. j. 2024, 66(1), 1 – 5. DOI: 10.18502/wkmj. v66i1.15598

91. Bao, C.; He, C. The role and therapeutic potential of MSC-derived exosomes in osteoarthritis. Arch. Biochem. 2021, 710, Art. No: 109002. DOI: 10.1016/j.abb.2021.109002

92. Carneiro, D. C.; Araújo, L. T.; Santos, G. C.; Damasceno, P. K. F.; Vieira, J. L.; Santos, R. R. D.; Barbosa, J. D. V.; Soares, M. B. P. Clinical Trials with Mesenchymal Stem Cell Therapies for Osteoarthritis: Challenges in the Regeneration of Articular Cartilage. Int. J. Mol. Sci. 2023, 24(12), Art. No: 9939. DOI: 10.3390/ijms24129939

93. DiIorio, S. E.; Young, B.; Parker, J. B.; Griffin, M. F.; Longaker, M. T. Understanding Tendon Fibroblast Biology and Heterogeneity. Biomedicines 2024, 12(4), Art. No: 859. DOI: 10.3390/biomedicines12040859

94. Burk, J. Mechanisms of Action of Multipotent Mesenchymal Stromal Cells in Tendon Disease. 2019, DOI: 10.5772/intechopen.83745

95. Koch, D.; Schnabel, L. Mesenchymal stem cell licensing: enhancing MSC function as a translational approach for the treatment of tendon injury. Am. J. Vet. Res. 2023, 84(10), 1-8. DOI: 10.2460/ajvr.23.07.0154

96. Tan, X.; Xiao, H.; Yan, A.; Li, M.; Wang, L. Effect of Exosomes from Bone Marrow–Derived Mesenchymal Stromal Cells and Adipose-Derived Stromal Cells on Bone-Tendon Healing in a Murine Rotator Cuff Injury Model. Orthop. J. Sports Med. 2024, 12(1), Art. No: 23259671231210304. DOI: 10.1177/23259671231210304

97. Volkova, N. Comparative study of the effect of bFGF and plasma rich in growth factors on cryopreserved multipotent mesenchymal stromal cells from bone marrow and tendon of rats. Cell Transplant. 2017, 5(2),170-175. DOI: 10.22494/cot.v5i2.75

98. Melzer, M.; Schubert, S.; Müller, S.; Geyer, J.; Hagen, A.; Niebert, S.; Burk, J. Rho/ROCK Inhibition Promotes TGF-β3-Induced Tenogenic Differentiation in Mesenchymal Stromal Cells. Stem Cells Int. 2021, 2021, Art. No: 8284690. DOI: 10.1155/2021/8284690

99. Liu, H.; Zhang, M.; Shi, M.; Zhang, T.; Lu, W.; Yang, S.; Cui, Q.; Li, Z. Adipose-derived mesenchymal stromal cell-derived exosomes promote tendon healing by activating both SMAD1/5/9 and SMAD2/3. Stem Cell Res. Ther. 2021, 12(1), Art. No: 338. DOI: 10.1186/s13287-021-02410-w

100. Quintero, D.; Orfei, C.; Kaplan, L.; Girolamo, L.; Best, T.; Kouroupis, D. The roles and therapeutic potentialof mesenchymal stem/stromal cells and their extracellular vesicles in tendinopathies. Front. Bioeng. Biotechnol. 2023, 11, Art. No: 1040762. DOI: 10.3389/fbioe.2023.1040762

101. M'Cloud, W.; Guzmán, K.; Panek, C.; Colbath, A. Stem cells and platelet-rich plasma for the treatment of naturally occurring equine tendon and ligament injuries: a systematic review and meta-analysis. Am. J. Vet. Med. Res. 2024, 262(S1), S50-S60. DOI: 10.2460/javma.23.12.0723

102. Bi, F.; Chen, Y.; Liu, J.; Hu, W.; Tian, K. Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold. Stem Cells Int. 2021, 2021, Art. No: 6697969. DOI: 10.1155/2021/6697969

103. Moon, S. W.; Park, S.; Oh, M.; Wang, J. H. Outcomes of human umbilical cord blood-derived mesenchymal stem cells in enhancing tendon-graft healing in anterior cruciate ligament reconstruction: an exploratory study. Knee Surg. Relat. Res. 2021, 33(1), Art. No: 32. DOI: 10.1186/s43019-021-00104-4

104. Jang, K.; Lim, H.; Hoon, B. Mesenchymal Stem Cells for Enhancing Biologic Healing after Anterior Cruciate Ligament Injuries. Curr. Stem. Cell Res. Ther. 2015, 10(6), 535-547. DOI: 10.2174/1574888x10666150528153025

105. Lui, P.; Leung, L. Practical Considerations for Translating Mesenchymal Stromal Cell-Derived Extracellular Vesicles from Bench to Bed. Pharmaceutics 2022, 14(8), Art. No: 1684. DOI: 10.3390/pharmaceutics14081684

106. Zhou T.; Yuan Z.; Weng J.; Pei D.; Du X.; He C.; Lai, P. Challenges and advances in clinical applications of mesenchymal stromal cells. J. Hematol. Oncol. 2021, 14, 1-24.

107. Tsai A.C.; Jeske R.; Chen X.; Yuan X.; Li Y. Influence of microenvironment on mesenchymal stem cell therapeutic potency: from planar culture to microcarriers. Front. Bioeng. Biotechnol. 2020, 8, Art. No: 640. DOI: 10.3389/fbioe.2020.00640.

108. Rodas, G.; Soler-Rich, R.; Rius-Tarruella, J.; Alomar, X.; Balius, R.; Orozco, L.; Masci, L.; Maffulli, N. Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study. Am. J. Sports Med. 2021, 49(6), 1492-1504. DOI: 10.1177/0363546521998725

109. Chun, S. W.; Kim, W.; Lee, S. Y.; Lim, C. Y.; Kim, K.; Kim, J. G.; Park, C. H.; Hong, S. H.; Yoo, H. J.; Chung, S. G. A randomized controlled trial of stem cell injection for tendon tear. Sci Rep. 2022, 12(1), Art. No: 818. DOI: 10.1038/s41598-021-04656-z

110. Lee, D. H.; Park, K. S.; Shin, H. E.; Kim, S. B.; Choi, H.; An, S. B.; Choi, H.; Kim, J. P.; Han, I. Safety and Feasibility of Intradiscal Administration of Matrilin-3-Primed Adipose-Derived Mesenchymal Stromal Cell Spheroids for Chronic Discogenic Low Back Pain: Phase 1 Clinical Trial. Int. J. Mol. Sci. 2023, 24(23), Art. No: 16827. DOI: 10.3390/ijms242316827

111. Kumar, H.; Ha, D. H.; Lee, E.J.; Park, J. H.; Shim, J. H.; Ahn, T. K.; Kim, K. T.; Ropper, A. E. Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study. Stem Cell Res. Ther. 2017, 8(1), Art. No: 262. DOI: 10.1186/s13287-017-0710-3

112. Kim, J. H.; Kim, K. I.; Yoon, W. K.; Song, S. J.; Jin, W. Intra-articular Injection of Mesenchymal Stem Cells After High Tibial Osteotomy in Osteoarthritic Knee: Two-Year Follow-up of Randomized Control Trial. Stem Cells Transl. Med. 2022, 11(6), 572-585. DOI: 10.1093/stcltm/szac023

113. Kim, K. I.; Lee, M. C.; Lee, J. H.; Moon, Y. W.; Lee, W. S.; Lee, H. J.; Hwang, S. C.; In, Y.; Shon, O. J.; Bae, K. C.; Song, S. J.; Park, K. K.; Kim, J. H. Clinical Efficacy and Safety of the Intra-Articular Injection of Autologous Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis: A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial. Am. J. Sports Med. 2023, 51(9), 2243-2253. DOI: 10.1177/03635465231179223

114. Sadri, B.; Hassanzadeh, M.; Bagherifard, A.; Mohammadi, J.; Alikhani, M.; Moeinabadi-Bidgoli, K.; Madani, H.; Diaz-Solano, D.; Karimi, S. Cartilage regeneration and inflammation modulation in knee osteoarthritis following injection of allogeneic adipose-derived mesenchymal stromal cells: a phase II, triple-blinded, placebo controlled, randomized trial. Stem Cell Res. Ther. 2023, 14(1), Art. No: 162. DOI: 10.1186/s13287-023-03359-8

115. Matas, J.; Orrego, M.; Amenabar, D.; Infante, C.; Tapia-Limonchi, R.; Cadiz, M. I.; Alcayaga-Miranda, F.; González, P. L. Umbilical Cord-Derived Mesenchymal Stromal Cells (MSCs) for Knee Osteoarthritis: Repeated MSC Dosing Is Superior to a Single MSC Dose and to Hyaluronic Acid in a Controlled Randomized Phase I/II Trial. Stem Cells Transl. Med. 2019, 8(3), 215–224. DOI: 10.1002/sctm.18-0053

116. Gupta, P. K.; Chullikana, A.; Rengasamy, M.; Shetty, N.; Pandey, V.; Agarwal, V.; Wagh, S. Y.; Vellotare, P. K. Efficacy and safety of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (Stempeucel®): preclinical and clinical trial in osteoarthritis of the knee joint. Arthritis Res.Ther. 2016, 18, Art. No: 301. DOI: 10.1186/s13075-016-1195-7

117. Freitag, J.; Bates, D.; Wickham, J.; Shah, K.; Huguenin, L.; Tenen, A.; Paterson, K.; Boyd, R. Adipose-Derived Mesenchymal Stem Cell Therapy in the Treatment of Knee Osteoarthritis: A Randomized Controlled Trial. Regen. Med. 2019, 14(3), 213–230. DOI: 10.2217/rme-2018-0161

118. Lamo-Espinosa, J. M.; Blanco, J. F.; Sánchez, M.; Moreno, V.; Granero-Moltó, F.; Sánchez-Guijo, F.; Crespo-Cullel, I.; Mora, G. Phase II multicenter randomized controlled clinical trial on the efficacy of intra-articular injection of autologous bone marrow mesenchymal stem cells with platelet rich plasma for the treatment of knee osteoarthritis. J. Transl. Med. 2020, 18(1), Art. No: 356. DOI: 10.1186/s12967-020-02530-6

119. Ho, K. K.; Lee, W. Y.; Griffith, J. F.; Ong, M. T.; Li, G. Randomized control trial of mesenchymal stem cells versus hyaluronic acid in patients with knee osteoarthritis - A Hong Kong pilot study. J. Orthop. Translat. 2022, 37, 69-77. DOI: 10.1016/j.jot.2022.07.012

120. Lim, H-C.; Park, Y-B.; Ha, C-W.; Cole, B. J.; Lee, B. K.; Jeong, H. J.; Kim, M. K.; Bin, S. Allogeneic Umbilical Cord Blood–Derived Mesenchymal Stem Cell Implantation Versus Microfracture for Large, Full-Thickness Cartilage Defects in Older Patients: A Multicenter Randomized Clinical Trial and Extended 5-Year Clinical Follow-up. Orthop. J. Sports Med. 2021, 9(1), Art. No: 2325967120973052. DOI: 10.1177/2325967120973052

121. Hashimoto, Y.; Nishida, Y.; Takahashi, S.; Nakamura, H.; Mera, H.; Kashiwa, K.; Yoshiya, S.; Inagaki, Y. Transplantation of autologous bone marrow-derived mesenchymal stem cells under arthroscopic surgery with microfracture versus microfracture alone for articular cartilage lesions in the knee: A multicenter prospective randomized control clinical trial. Regen. Ther. 2019, 28(11), 106-113. DOI: 10.1016/j.reth.2019.06.002

Nour MOBAYED

nourmobayed.nm@gmail.com

Affiliation:

a:1:{s:5:"en_US";s:20:"university of aleppo";} Syrian Arab Republic

Dima Joujeh

Affiliation:

Biotechnology engineering, Faculty of Technical Engineering, University of Aleppo, Aleppo, Syria Syrian Arab Republic