Intra-articular Injection of MSCs in Treatment of Knee OA

Inclusion Criteria: 1. Patients between 40-75 years of age with symptomatic moderate to severe (Kellgren-Lawrence III or IV) primary osteoarthritis of the knee 2. Idiopathic or secondary osteoarthritis of the knee with grade 2,3, or 4 radiographic severity, as defined by the modified Kellgren-Lawrence classification 3. No history of prior intra-articular cortisone, hyaluronic acid, or platelet-rich plasma injection within the previous six months 4. No history of prior arthroscopic knee surgery or open knee surgery on the ipsilateral side within the past year 5. Adequate bone marrow, liver, and renal functions 6. Body weight \>40 kg 7. Body Mass Index \<40 8. Negative for (HIV, HTLV1\&2, Hep A, B, C, syphilis) infection as determined by approved serological testing 9. Negative for pregnancy as determined by a serum pregnancy test. Females of childbearing potential will be required to practice abstinence or use an effective form of contraception for 12 months following their MSC injection. 10. Ability to provide written informed consent. Exclusion Criteria: 1. Patients with clinically unstable knee due to the presence of a complete anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and/or posterolateral corner tear 2. Patients with varus or valgus malalignment \>5 degrees as measured by 4 foot standing antero-posterior radiographs 3. Patients with a history of a previous subtotal medial or lateral meniscectomy 4. Patients with a history of septic arthritis in the affected joint 5. Patients with a history of a prior intra-articular knee fracture 6. Severe bleeding diathesis 7. Contraindication to bone marrow aspiration and/or biopsy 8. Active infection 9. Bone marrow failure 10. Cytopenia 11. Patients who have previously received radiotherapy to the pelvis 12. Patients who have been on chemotherapy from within a year of the date of informed 13. Patients with positive serological test for (HIV, HTLV1\&2, Hep A, B, C, syphilis) 14. Pregnancy or risk of pregnancy (this includes participants that are not willing to practice active contraception for the duration of the study) 15. Patients with unforeseen conditions that are deemed unsafe or inappropriate for the study (e.g. patients who are claustrophobic and cannot undergo an MRI) as per the discretion of the principal investigator