Biosynthetic scaffolds for partial meniscal loss: A systematic review from animal models to clinical practice

被引:23
|
作者
Veronesi, F. [1 ]
Di Matteo, B. [2 ,7 ]
Vitale, N. D. [2 ,3 ]
Filardo, G. [4 ,5 ,6 ]
Visani, A. [1 ]
Kon, E. [2 ,3 ]
Fini, M. [1 ]
机构
[1] IRCCS Ist Ortoped Rizzoli, Complex Struct Surg Sci & Technol, Bologna, Italy
[2] Humanitas Univ, Dept Biomed Sci, Via Rita Levi Montalcini 4, I-20090 Milan, Italy
[3] IRCCS Humanitas Res Hosp, Via Manzoni 56, I-20089 Milan, Italy
[4] IRCCS Ist Ortoped Rizzoli, Appl & Translat Res Ctr, Bologna, Italy
[5] Osped Reg Lugano, Orthopaed & Traumatol Unit, EOC, Lugano, Switzerland
[6] Univ Svizzera Italiana, Fac Biomed Sci, Lugano, Switzerland
[7] First Moscow State Med Univ Sechenov Univ, Bolshaya Pirogovskaya Ulitsa 19c1, Moscow 119146, Russia
基金
欧盟地平线“2020”;
关键词
Meniscal scaffold; Meniscectomy; Osteoarthritis; Regenerative medicine; Collagen; Polyurethane; MESENCHYMAL STEM-CELLS; FIBER-REINFORCED SCAFFOLD; PARTIAL MEDIAL MENISCECTOMY; LONG-TERM OUTCOMES; 10-YEAR FOLLOW-UP; POLYURETHANE SCAFFOLD; COLLAGEN MENISCUS; IN-VIVO; ALLOGRAFT TRANSPLANTATION; FUNCTIONAL OUTCOMES;
D O I
10.1016/j.bioactmat.2021.03.033
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Acute or degenerative meniscus tears are the most common knee lesions. Meniscectomy provides symptomatic relief and functional recovery only in the short- to mid-term follow-up but significantly increases the risk of osteoarthritis. For this reason, preserving the meniscus is key, although it remains a challenge. Allograft transplants present many disadvantages, so during the last 20 years preclinical and clinical research focused on developing and investigating meniscal scaffolds. The aim of this systematic review was to collect and evaluate all the available evidence on biosynthetic scaffolds for meniscus regeneration both in vivo and in clinical studies. Three databases were searched: 46 in vivo preclinical studies and 30 clinical ones were found. Sixteen natural, 15 synthetic, and 15 hybrid scaffolds were studied in vivo. Among them, only 2 were translated into clinic: the Collagen Meniscus Implant, used in 11 studies, and the polyurethane-based scaffold Actifit (R), applied in 19 studies. Although positive outcomes were described in the short- to mid-term, the number of concurrent procedures and the lack of randomized trials are the major limitations of the available clinical literature. Few in vivo studies also combined the use of cells or growth factors, but these augmentation strategies have not been applied in the clinical practice yet. Current solutions offer a significant but incomplete clinical improvement, and the regeneration potential is still unsatisfactory. Building upon the overall positive results of these "old" technologies to address partial meniscal loss, further innovation is urgently needed in this field to provide patients better joint sparing treatment options.
引用
收藏
页码:3782 / 3800
页数:19
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