PDF(Pubmed)
Abstract：
BACKGROUND: Meniscal repair should be the gold standard. However, the meniscus is poorly vascularized and even an excellent meniscus repair may not heal. Therefore, numerous studies and systematic reviews have been carried out on platelet-rich plasma (PRP), mesenchymal stem cells (MSCs) and fibrin clots for meniscal augmentation, but the results remain controversial. This systematic review aimed to identify other emerging strategies for meniscal repair augmentation and to assess whether there are different avenues to explore in this field.
METHODS: A systematic literature review was conducted in August 2022. PubMed, Ovid MEDLINE(R) all, Ovid All EBM Reviews, Ovid Embase and ISI Web of Science databases were searched. In Vivo animal and human studies concerning the biological augmentation of meniscal lesions by factors other than PRP, MSCs or fibrin clots were included. Cartilage-only studies, previous systematic reviews and expert opinions were excluded. All data were analyzed by two independent reviewers.
RESULTS: Of 8965 studies only nineteen studies covering 12 different factors met the inclusion criteria. Eight studies investigated the use of growth factors for meniscal biologic augmentation, such as vascular endothelial growth factor or bone morphogenic protein 7. Five studies reported on cell therapy and six studies focused on other factors such as hyaluronic acid, simvastatin or atelocollagen. Most studies (n = 18) were performed on animal models with gross observation and histological evaluation as outcomes. Polymerase chain reaction and immunohistochemistry were also common. Biomechanical testing was the object of only two studies.
CONCLUSIONS: Although several augmentation strategies have been attempted, none has yielded conclusive results, testifying to a lack of understanding with regard to meniscal healing. More research is needed to better understand the pathways that regulate meniscus repair and how to act positively on them.
METHODS: Systematic review of case-control and animal laboratory studies.
METHODS: A systematic literature review was conducted in August 2022. PubMed, Ovid MEDLINE(R) all, Ovid All EBM Reviews, Ovid Embase and ISI Web of Science databases were searched. In Vivo animal and human studies concerning the biological augmentation of meniscal lesions by factors other than PRP, MSCs or fibrin clots were included. Cartilage-only studies, previous systematic reviews and expert opinions were excluded. All data were analyzed by two independent reviewers.
RESULTS: Of 8965 studies only nineteen studies covering 12 different factors met the inclusion criteria. Eight studies investigated the use of growth factors for meniscal biologic augmentation, such as vascular endothelial growth factor or bone morphogenic protein 7. Five studies reported on cell therapy and six studies focused on other factors such as hyaluronic acid, simvastatin or atelocollagen. Most studies (n = 18) were performed on animal models with gross observation and histological evaluation as outcomes. Polymerase chain reaction and immunohistochemistry were also common. Biomechanical testing was the object of only two studies.
CONCLUSIONS: Although several augmentation strategies have been attempted, none has yielded conclusive results, testifying to a lack of understanding with regard to meniscal healing. More research is needed to better understand the pathways that regulate meniscus repair and how to act positively on them.
METHODS: Systematic review of case-control and animal laboratory studies.
摘要：
背景：半月板修复应该是黄金标准。然而,半月板血管化不良，即使是出色的半月板修复也可能无法愈合。因此,已经对富血小板血浆（PRP）进行了大量研究和系统评价，间充质干细胞（MSCs）和纤维蛋白凝块用于半月板增强，但结果仍有争议。本系统综述旨在确定半月板修复增强的其他新兴策略，并评估该领域是否有不同的探索途径。
方法：于2022年8月进行了系统文献综述。PubMed,OvidMEDLINE(R)全部,Ovid所有EBM评论,搜索了OvidEmbase和ISIWebofScience数据库。在体内动物和人体研究中，有关PRP以外的因素对半月板病变的生物学增强，包括MSC或纤维蛋白凝块。仅软骨研究,以前的系统评价和专家意见被排除在外.所有数据均由两名独立的审阅者进行分析。
结果：在8965项研究中，只有19项涵盖12个不同因素的研究符合纳入标准。八项研究调查了使用生长因子进行半月板生物学增强，如血管内皮生长因子或骨形态发生蛋白7。五项研究报道了细胞疗法，六项研究集中在其他因素，如透明质酸，辛伐他汀或去胶原。大多数研究（n=18）是在动物模型上进行的，以粗略观察和组织学评估作为结果。聚合酶链反应和免疫组织化学也很常见。生物力学测试仅是两项研究的对象。
结论：尽管已经尝试了几种增强策略，没有产生决定性的结果，证明对半月板愈合缺乏了解。需要更多的研究来更好地了解调节半月板修复的途径以及如何对它们采取积极的行动。
方法：病例对照和动物实验室研究的系统评价。
方法：于2022年8月进行了系统文献综述。PubMed,OvidMEDLINE(R)全部,Ovid所有EBM评论,搜索了OvidEmbase和ISIWebofScience数据库。在体内动物和人体研究中，有关PRP以外的因素对半月板病变的生物学增强，包括MSC或纤维蛋白凝块。仅软骨研究,以前的系统评价和专家意见被排除在外.所有数据均由两名独立的审阅者进行分析。
结果：在8965项研究中，只有19项涵盖12个不同因素的研究符合纳入标准。八项研究调查了使用生长因子进行半月板生物学增强，如血管内皮生长因子或骨形态发生蛋白7。五项研究报道了细胞疗法，六项研究集中在其他因素，如透明质酸，辛伐他汀或去胶原。大多数研究（n=18）是在动物模型上进行的，以粗略观察和组织学评估作为结果。聚合酶链反应和免疫组织化学也很常见。生物力学测试仅是两项研究的对象。
结论：尽管已经尝试了几种增强策略，没有产生决定性的结果，证明对半月板愈合缺乏了解。需要更多的研究来更好地了解调节半月板修复的途径以及如何对它们采取积极的行动。
方法：病例对照和动物实验室研究的系统评价。
