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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Dec 26, 2025; 17(12): 112778
Published online Dec 26, 2025. doi: 10.4252/wjsc.v17.i12.112778
Published online Dec 26, 2025. doi: 10.4252/wjsc.v17.i12.112778
Does standalone/combined subchondral bone marrow-derived mesenchymal stem/stromal cell injection offer significantly better clinical benefit to intraarticular injection in knee osteoarthritis?
Arulkumar Nallakumarasamy, Sandeep Shrivastava, Naveen Jeyaraman, Department of Or
Arulkumar Nallakumarasamy, Ravi Velamoor Rangarajan, Naveen Jeyaraman, Avinash Gandi Devadas, Madhan Jeyaraman, Department of Regenerative Medicine, Mother Cell Regenerative Centre, Tiruchirappalli 620017, Tamil Nadu, India
Arulkumar Nallakumarasamy, Naveen Jeyaraman, Swaminathan Ramasubramanian, Sathish Muthu, Madhan Jeyaraman, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Asawari Bapat, Department of Stem Cells and Regenerative Medicine, Infohealth FZE, Dubai 6824, United Arab Emirates
Asawari Bapat, Department of Stem Cells and Regenerative Medicine, Questar Enterprise, LLC, Dubai 6824, United Arab Emirates
Asawari Bapat, Department of Stem Cells and Regenerative Medicine, Clinical Affairs, Regenerative Outcomes, Nashville, TN 40211, United States
Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Author contributions: Nallakumarasamy A designed the research; Nallakumarasamy A and Jeyaraman N analyzed the articles for performing review; Nallakumarasamy A, Jeyaraman N, and Ramasubramanian S wrote the manuscript; Shrivastava S, Ravi VR, Devadas AG, Muthu S, Bapat A, and Jeyaraman M finalized the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Madhan Jeyaraman, MD, PhD, Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Received: August 6, 2025
Revised: September 16, 2025
Accepted: November 12, 2025
Published online: December 26, 2025
Processing time: 141 Days and 19.7 Hours
Revised: September 16, 2025
Accepted: November 12, 2025
Published online: December 26, 2025
Processing time: 141 Days and 19.7 Hours
Core Tip
Core Tip: Subchondral bone-targeted bone marrow aspirate concentrate therapy offers a promising biologic approach for knee osteoarthritis, outperforming intra-articular delivery in symptom relief and structural preservation. Addressing bone marrow lesions and mesenchymal stem cell depletion within the subchondral zone enhances pain scores, functional outcomes, and cartilage integrity while delaying total knee arthroplasty. These findings support a paradigm shift toward whole-joint biologic interventions that modify disease progression rather than merely alleviating symptoms.