Abstract
Background Osteoarthritis (OA) represents a major global health challenge with no ideal treatment options available. Early-stage treatment typically focuses on symptomatic relief of pain and stiffness; while late-stage patients can only opt for surgical interventions such as joint replacement to improve quality of life. Cell-free therapy based on extracellular vesicles (EVs) has offered a novel therapeutic approach for regulating bone metabolism and repairing cartilage, demonstrating emerging potential. Methods Publications related to OA and Cell-free therapy based on EVs were retrieved from the Web of Science Core Collection database from 1991 to 2024. Our study employed bibliometric methods to analyze publication trends, leading contributing countries, institutions, authors, journals, and emerging trends and research directions. Results The analysis has revealed a rapid growth in publications since 2019. China dominated both in terms of publication output and citation counts. The most productive institution is Shanghai Jiao Tong University. The most prolific publishing outlet journal was the International Journal of Molecular Sciences , while in terms of citation impact, Biomaterials ranked first. De Girolamo, Laura from Aix-Marseille Universite and Ragni, Enrico from IRCCS Istituto Ortopedico Galeazzi shared the top position in publication output, while Noel, Daniele from the Universite de Montpellier was the author receiving the most citations. Research primarily clustered around key themes including: (1) therapeutic mechanisms of cell-free treatment based on EVs in OA, (2) research advances in cell-free treatment based on EVs, (3) exosome engineering, and (4) a novel drug delivery system for EVs. Conclusion This is the first bibliometric study on cell-free therapy based on EVs for OA, providing orthopedic and regenerative medicine experts with comprehensive perspectives on the field's current status and future development directions.