![]() ![]() A variety of endogenous ( e.g., age, sex) and exogenous (obesity, patient’s lifestyle) risk factors for OA have also been outlined. In regards to the epidemiology of knee OA (Table (Table1), 1), studies indicate that knee osteoarthritis in men aged 60 to 64 is usually found in the right knee (23%) than in the left knee (16.3%), while distribution seems to be more evenly balanced in women of the same age (right knee, 24.2% left knee, 24.7%). It is believed that synovial inflammation is a response of synovial macrophages to cartilage debris and catabolic mediators entering the synovial cavity. Moreover, it correlates to clinical signs of knee OA such as swelling of the knee and inflammatory pain. ![]() Recently, synovial inflammation has also been accredited as a factor limiting knee cartilage repair. The pathogenesis of knee OA have been linked to biomechanical and biochemical changes in the cartilage of the knee joint ( e.g., inability to withstand normal mechanical stresses, limited supply of nutrients and oxygen, inadequate synthesis of extracellular matrix components, increased synthesis of tissue-destructive proteinases (matrix metalloproteinases and aggrecanases) and overall apoptosis of chondrocytes). Comparison between a normal and diseased joint (Illustration created after Felson and Buja et al) Furthermore, based on their critical assessment of the present academic literature the authors of this review share their vision about the future of stem cell applications in the treatment of knee osteoarthritis. In addition to the latest advances in the field, challenges associated with stem cell therapy regarding knee cartilage regeneration and chondrogenesis in vitro and in vivo are also outlined and analyzed. The aim of this review is to outline the latest advances in stem cell therapy for knee osteoarthritis as well as highlight some of the advantages of stem cell therapy over traditional approaches aimed at restoration of cartilage function in the knee. Total knee replacements come together with high effort and costs and are not always successful. ![]() Moreover, in severe cases of knee osteoarthritis total knee replacement may be required. While conventional treatments like physiotherapy or drugs offer temporary relief of clinical symptoms, restoration of normal cartilage function has been difficult to achieve. By some estimations in 2030, only in the United States, this medical condition will burden 67 million people. It is characterized by degeneration of the cartilage substance inside the knee which leads to pain, stiffness and tenderness. Knee osteoarthritis is a chronic, indolent disease that will affect an ever increasing number of patients, especially the elderly and the obese. ![]()
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