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World J Orthop. Apr 18, 2026; 17(4): 116916
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.116916
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.116916
Comparative outcomes of intra-articular, subchondral, and combined injections of peripheral blood mesenchymal stromal cells in knee osteoarthritis
Harish V K Ratna, Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nādu, India
Naveen Jeyaraman, Arulkumar Nallakumarasamy, Sathish Muthu, Madhan Jeyaraman, Depart
Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman, Department of Orthopaedics, Ortho
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchanpalli 631552, Telangāna, India
Author contributions: Ratna HVK, Jeyaraman N, and Nallakumarasamy A analyzed the articles for performing review and wrote the manuscript; Jeyaraman N designed the research; Muthu S and Jeyaraman M finalized the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Sri Lalithambigai Medical College and Hospital (Approval No. Dr. MGR-ERI/SLMCH/2025/027).
Clinical trial registration statement: This trial has been registered on the Clinical Trials Registry - India, the registration No. CTRI/2025/11/097029.
Informed consent statement: All participants have signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: All data is contained within the manuscript.
Corresponding author: Madhan Jeyaraman, MS, PhD, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nādu, India. madhanjeyaraman@gmail.com
Received: November 25, 2025
Revised: December 23, 2025
Accepted: February 9, 2026
Published online: April 18, 2026
Processing time: 137 Days and 3 Hours
Revised: December 23, 2025
Accepted: February 9, 2026
Published online: April 18, 2026
Processing time: 137 Days and 3 Hours
Core Tip
Core Tip: Optimizing delivery routes for peripheral blood-derived mesenchymal stromal cells is key to enhancing regenerative outcomes in early-grade knee osteoarthritis. This trial compares intra-articular, subchondral, and combined injection techniques using clinical scores and advanced imaging over 12 months. The goal is to establish minimally invasive, evidence-based protocols that improve function, reduce pain, and delay progression - aligned with the Indian healthcare context and regenerative medicine advancements.