Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review
Abstract Background The efficacy and safety profile of mesenchymal stem cells (MSCs) augmentation in chondral procedures are controversial. This systematic review updated the current evidence on MSCs augmentation for chondral procedures in patients with symptomatic chondral defects of the knee. Meth...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03311-1 |
| _version_ | 1818021293623083008 |
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| author | Migliorini Filippo Mangiavini Laura Giorgino Riccardo Vismara Valeria Jörg Eschweiler Nicola Maffulli |
| author_facet | Migliorini Filippo Mangiavini Laura Giorgino Riccardo Vismara Valeria Jörg Eschweiler Nicola Maffulli |
| author_sort | Migliorini Filippo |
| collection | DOAJ |
| description | Abstract Background The efficacy and safety profile of mesenchymal stem cells (MSCs) augmentation in chondral procedures are controversial. This systematic review updated the current evidence on MSCs augmentation for chondral procedures in patients with symptomatic chondral defects of the knee. Methods This study followed the PRISMA guidelines. The literature search was updated in August 2022. Two independent authors accessed PubMed, Google scholar, Embase, and Scopus. No additional filters or time constrains were used for the search. A cross reference of the bibliographies was also performed. All the clinical studies investigating surgical procedures for chondral defects of the knee augmented with MSCs were accessed. Defects of both tibiofemoral and patellofemoral joints were included. The following patient reported outcomes measures (PROMs) were retrieved at baseline and last follow-up: Visual Analogic Scale (VAS), Tegner Activity Scale, Lysholm Knee Scoring System, International Knee Documentation Committee (IKDC). Return to daily activities and data on hypertrophy, failure, revision surgery were also collected. Failures were defined as the recurrence of symptoms attributable to the index procedure. Revisions were defined as any reoperation at the site of the index procedure. Results A total of 15 clinical studies (411 procedures) were included. Patients returned to their prior sport activity at 2.8 ± 0.4 months. All the PROMs improved at last follow-up: Tegner (P = 0.0002), Lysholm (P < 0.0001), the IKDC (P < 0.0001), VAS (P < 0.0001). At a mean of 30.1 ± 13.9 months, 3.1% (2 of 65 patients) reported graft hypertrophy, 3.2% (2 of 63) were considered failures. No surgical revision procedures were reported. Given the lack of available quantitative data for inclusion, a formal comparison of surgical procedures was not conducted. Conclusion MSCs augmentation in selected chondral procedures could be effective, with a low rate of complications. Further investigations are required to overcome the current limitations to allow the clinical translation of MSCs in regenerative medicine. |
| first_indexed | 2024-04-14T08:15:51Z |
| format | Article |
| id | doaj.art-bd0d0b13a8504b3d871838b2c8bead58 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T08:15:51Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-bd0d0b13a8504b3d871838b2c8bead582022-12-22T02:04:24ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-09-011711810.1186/s13018-022-03311-1Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic reviewMigliorini Filippo0Mangiavini Laura1Giorgino Riccardo2Vismara Valeria3Jörg Eschweiler4Nicola Maffulli5Department of Orthopedic, Trauma, and Reconstructive Surgery, RWTH Aachen University HospitalIRCCS Istituto Ortopedico GaleazziDepartment of Biomedical Sciences for Health, University of MilanIRCCS Istituto Ortopedico GaleazziDepartment of Orthopedic, Trauma, and Reconstructive Surgery, RWTH Aachen University HospitalDepartment of Medicine, Surgery and Dentistry, University of SalernoAbstract Background The efficacy and safety profile of mesenchymal stem cells (MSCs) augmentation in chondral procedures are controversial. This systematic review updated the current evidence on MSCs augmentation for chondral procedures in patients with symptomatic chondral defects of the knee. Methods This study followed the PRISMA guidelines. The literature search was updated in August 2022. Two independent authors accessed PubMed, Google scholar, Embase, and Scopus. No additional filters or time constrains were used for the search. A cross reference of the bibliographies was also performed. All the clinical studies investigating surgical procedures for chondral defects of the knee augmented with MSCs were accessed. Defects of both tibiofemoral and patellofemoral joints were included. The following patient reported outcomes measures (PROMs) were retrieved at baseline and last follow-up: Visual Analogic Scale (VAS), Tegner Activity Scale, Lysholm Knee Scoring System, International Knee Documentation Committee (IKDC). Return to daily activities and data on hypertrophy, failure, revision surgery were also collected. Failures were defined as the recurrence of symptoms attributable to the index procedure. Revisions were defined as any reoperation at the site of the index procedure. Results A total of 15 clinical studies (411 procedures) were included. Patients returned to their prior sport activity at 2.8 ± 0.4 months. All the PROMs improved at last follow-up: Tegner (P = 0.0002), Lysholm (P < 0.0001), the IKDC (P < 0.0001), VAS (P < 0.0001). At a mean of 30.1 ± 13.9 months, 3.1% (2 of 65 patients) reported graft hypertrophy, 3.2% (2 of 63) were considered failures. No surgical revision procedures were reported. Given the lack of available quantitative data for inclusion, a formal comparison of surgical procedures was not conducted. Conclusion MSCs augmentation in selected chondral procedures could be effective, with a low rate of complications. Further investigations are required to overcome the current limitations to allow the clinical translation of MSCs in regenerative medicine.https://doi.org/10.1186/s13018-022-03311-1KneeChondral defectsMesenchymal stem cellsMSCs |
| spellingShingle | Migliorini Filippo Mangiavini Laura Giorgino Riccardo Vismara Valeria Jörg Eschweiler Nicola Maffulli Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review Journal of Orthopaedic Surgery and Research Knee Chondral defects Mesenchymal stem cells MSCs |
| title | Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review |
| title_full | Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review |
| title_fullStr | Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review |
| title_full_unstemmed | Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review |
| title_short | Mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee: a systematic review |
| title_sort | mesenchymal stem cells augmentation for surgical procedures in patients with symptomatic chondral defects of the knee a systematic review |
| topic | Knee Chondral defects Mesenchymal stem cells MSCs |
| url | https://doi.org/10.1186/s13018-022-03311-1 |
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