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. 2024 Jul 13;25(1):541.
doi: 10.1186/s12891-024-07644-2.

Emerging biologic augmentation strategies for meniscal repair: a systematic review

David Mazy  1 , Jessica Wang  2 , Philippe Dodin  1 , Daisy Lu  2 , Florina Moldovan  1 , Marie-Lyne Nault  3   4   5   6
Affiliations

Emerging biologic augmentation strategies for meniscal repair: a systematic review

David Mazy et al. BMC Musculoskelet Disord. .

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.

Level of evidence: Systematic review of case-control and animal laboratory studies.

Keywords: Biologic augmentation; Cell therapy; Growth factors; Meniscal repair.

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Conflict of interest statement

Marie-Lyne Nault: The institution (Hopital Sacré-Coeur de Montréal) has received departmental funding for research and educational purposes from: Arthrex, Conmed, Depuy, Linvatec, Smith & Nephew, Stryker, Synthes, Tornier, Wright, Zimmer Biomet. Departmental funding was also provided to CHU Sainte-Justine from Orthopaediatrics. This project did not receive any funding from these entities and they were not involved in any aspect of the submitted work. The other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Years of publication of the 19 extracted studies
Fig. 3
Fig. 3
Distribution of factors by categories
See this image and copyright information in PMC

References

    1. Clayton RAE, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008;39(12):1338–1344. doi: 10.1016/j.injury.2008.06.021. - DOI - PubMed
    1. Jacquet C, Pujol N, Pauly V, Beaufils P, Ollivier M. Analysis of the trends in arthroscopic meniscectomy and meniscus repair procedures in France from 2005 to 2017. Orthop Traumatol Surg Res OTSR. 2019;105(4):677–682. doi: 10.1016/j.otsr.2019.01.024. - DOI - PubMed
    1. Abrams GD, Frank RM, Gupta AK, Harris JD, McCormick FM, Cole BJ. Trends in meniscus repair and meniscectomy in the United States, 2005–2011. Am J Sports Med. 2013;41(10):2333–2339. doi: 10.1177/0363546513495641. - DOI - PubMed
    1. Seil R, Becker R. Time for a paradigm change in meniscal repair: save the meniscus! Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2016;24(5):1421–1423. doi: 10.1007/s00167-016-4127-9. - DOI - PubMed
    1. Bąkowski P, Bąkowska-Żywicka K, Ciemniewska-Gorzela K, Piontek T. Meniscectomy is still a frequent orthopedic procedure: a pending need for education on the meniscus treatment possibilities. Knee Surg Sports Traumatol Arthrosc. 2022;30(4):1430–1435. doi: 10.1007/s00167-021-06612-w. - DOI - PMC - PubMed

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