Clinical Impact of Meniscal Scaffold Implantation in Patients with Meniscal Tears: A Systematic Review.

IF 1.9 2区 医学 Q2 ORTHOPEDICS
Clinics in Orthopedic Surgery Pub Date : 2025-02-01 Epub Date: 2025-01-14 DOI:10.4055/cios24285
Joo Hyung Han, Min Jung, Kwangho Chung, Se-Han Jung, Hyunjun Lee, Chong-Hyuk Choi, Sung-Hwan Kim
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引用次数: 0

Abstract

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds.

Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included.

Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between -5.90 and -4.40. In the case of visual analog scale score, the MD ranged from -1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of -2.0 to 0.4.

Conclusions: There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

半月板支架植入对半月板撕裂患者的临床影响:一项系统综述。
背景:半月板支架植入术作为半月板损伤的一种治疗方法已被引入,但其临床影响,包括其软骨保护作用,仍没有明确的共识。本综述旨在评估半月板支架植入与半月板切除术相比的软骨保护作用、临床结果和生存期,以及不同类型支架之间的差异。方法:对PubMed、Embase、Cochrane Library和谷歌Scholar等数据库进行综合检索,包括截至2024年6月1日发表的文章。随机对照试验(RCT)和英文发表的比较研究报道了使用胶原半月板植入物(CMI)和聚氨酯半月板支架治疗半月板撕裂的结果。结果:在数据库中初步确定了421项研究,并对8项研究进行了系统评价,涉及596例患者。在涉及软骨保护作用的5项研究中,没有一项研究发现半月板支架比半月板切除术具有更高的软骨保护作用。在比较CMI和半月板切除术的研究中,Lysholm评分结果显示平均差异(MD)范围在-5.90和-4.40之间。在视觉模拟量表评分的情况下,MD范围为-1.0至1.0。在比较聚氨酯半月板支架和CMI的研究中,Tegner评分结果显示MD范围为-2.0到0.4。结论:与半月板切除术相比,CMI和聚氨酯半月板支架在软骨保护作用上没有优势。虽然半月板支架可以改善临床结果,但与半月板切除术相比,没有观察到临床相关的差异。两种支架之间没有明显的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
4.00%
发文量
85
审稿时长
36 weeks
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