60 patients with bilateral secondary knee osteoarthritis to corticosteroid-induced osteonecrosis were randomized to have one knee treated with subchondral injection of mesenchymal stem cells, and one knee treated with total knee arthroplasty. Patients were assessed over a minimum of 8 years after treatment. Results demonstrated no significant difference between groups in outcome on the Knee Society Score at final follow-up. Rate of secondary surgical intervention was 3/30 among knees administration subchondral MSC injection and 6/30 among knees managed with TKA.