Combined arthroscopic rotator cuff repair with mesenchymal stem cell augmentation shows similar functional outcomes but a higher structural integrity rate compared with isolated repair: a meta-analysis of comparative studies

Q2 Medicine

JSES International Pub Date : 2025-07-01 DOI:10.1016/j.jseint.2025.03.017

Erminia Cofano MD, PhD , Roberto Minici MD , Giovanna Spina MD , Domenico Laganà MD , Olimpio Galasso MD , Giorgio Gasparini MD , Italian Orthopaedic Research Society, Michele Mercurio MD

{"title":"Combined arthroscopic rotator cuff repair with mesenchymal stem cell augmentation shows similar functional outcomes but a higher structural integrity rate compared with isolated repair: a meta-analysis of comparative studies","authors":"Erminia Cofano MD, PhD , Roberto Minici MD , Giovanna Spina MD , Domenico Laganà MD , Olimpio Galasso MD , Giorgio Gasparini MD , Italian Orthopaedic Research Society, Michele Mercurio MD","doi":"10.1016/j.jseint.2025.03.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic rotator cuff repair (RCR) has guaranteed satisfactory outcomes but remains associated with a significant rate of tendon-bone healing failure. Mesenchymal stem cells (MSCs) have been tested as a promising cell-based therapy for rotator cuff tear (RCT). MSC augmentation has been proposed as a therapy associated with surgical repair, potentially enhancing the overall surgical outcomes for patients with RCTs. The aim of this meta-analysis was to compare functional and structural outcomes between arthroscopic RCR combined with MSC augmentation vs. isolated RCR for RCT.</div></div><div><h3>Methods</h3><div>The PubMed, MEDLINE, Scopus, and Cochrane Central databases were used to search keywords, and 5 studies were included. The first author, journal name, year of publication, study design, patient demographics, type of surgery, and follow-up period were recorded. The data extracted for quantitative analysis included the visual analog scale, University of California at Los Angeles score, flexion, external rotation, and retear. Random and fixed effect models were used for the meta-analysis of pooled mean differences and odds ratios.</div></div><div><h3>Results</h3><div>A total of 415 patients were identified, 203 of whom underwent combined RCR and MSC augmentation, and 212 underwent isolated RCR. The mean ages were 62.2 ± 6.2 and 61.6 ± 5.7 years in the combined RCR and MSC injection and isolated RCR groups, respectively. The mean follow-up was 17.5 ± 8.7 and 17.6 ± 8 months. Comparable postoperative visual analog scale score (<em>P</em> = .59), flexion (<em>P</em> = .68), external rotation (<em>P</em> = .42), and University of California at Los Angeles score (<em>P</em> = .92) were found between the groups. Significantly higher rotator cuff retear rate was found in the isolated RCR group (17.7% and 35% for the RCR and MSC injection and isolated RCR groups, respectively; odds ratio = −0.19, 95% confidence interval [−0.34, −0.04], <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. Pain and functional outcomes were similar between the two groups.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1191-1198"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JSES International","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666638325000994","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Arthroscopic rotator cuff repair (RCR) has guaranteed satisfactory outcomes but remains associated with a significant rate of tendon-bone healing failure. Mesenchymal stem cells (MSCs) have been tested as a promising cell-based therapy for rotator cuff tear (RCT). MSC augmentation has been proposed as a therapy associated with surgical repair, potentially enhancing the overall surgical outcomes for patients with RCTs. The aim of this meta-analysis was to compare functional and structural outcomes between arthroscopic RCR combined with MSC augmentation vs. isolated RCR for RCT.

Methods

The PubMed, MEDLINE, Scopus, and Cochrane Central databases were used to search keywords, and 5 studies were included. The first author, journal name, year of publication, study design, patient demographics, type of surgery, and follow-up period were recorded. The data extracted for quantitative analysis included the visual analog scale, University of California at Los Angeles score, flexion, external rotation, and retear. Random and fixed effect models were used for the meta-analysis of pooled mean differences and odds ratios.

Results

A total of 415 patients were identified, 203 of whom underwent combined RCR and MSC augmentation, and 212 underwent isolated RCR. The mean ages were 62.2 ± 6.2 and 61.6 ± 5.7 years in the combined RCR and MSC injection and isolated RCR groups, respectively. The mean follow-up was 17.5 ± 8.7 and 17.6 ± 8 months. Comparable postoperative visual analog scale score (P = .59), flexion (P = .68), external rotation (P = .42), and University of California at Los Angeles score (P = .92) were found between the groups. Significantly higher rotator cuff retear rate was found in the isolated RCR group (17.7% and 35% for the RCR and MSC injection and isolated RCR groups, respectively; odds ratio = −0.19, 95% confidence interval [−0.34, −0.04], P = .01).

Conclusion

Arthroscopic surgical repair combined with MSC augmentation reported better structural outcomes compared to isolated surgical repair for RCT. Pain and functional outcomes were similar between the two groups.

查看原文本刊更多论文

联合关节镜下肩袖修复联合间充质干细胞增强显示出类似的功能结果，但与孤立修复相比，结构完整性更高：一项比较研究的荟萃分析

背景：关节镜下肩袖修复术（RCR）保证了令人满意的结果，但仍然与肌腱-骨愈合失败率显著相关。间充质干细胞（MSCs）已被证明是一种很有前途的基于细胞的治疗肩袖撕裂（RCT）的方法。MSC增强已被提议作为一种与手术修复相关的治疗方法，可能会提高随机对照试验患者的整体手术效果。本荟萃分析的目的是比较关节镜下RCR联合MSC增强与单独RCR的功能和结构结果。方法采用PubMed、MEDLINE、Scopus、Cochrane Central数据库检索关键词，共纳入5篇研究。记录第一作者、期刊名称、发表年份、研究设计、患者人口统计学、手术类型和随访期。提取的数据用于定量分析，包括视觉模拟量表、加州大学洛杉矶分校评分、屈曲、外旋和折回。采用随机效应和固定效应模型对合并平均差异和优势比进行meta分析。结果共发现415例患者，其中203例接受RCR联合MSC增强，212例接受单独RCR。RCR与MSC联合注射组和单独RCR组的平均年龄分别为62.2±6.2岁和61.6±5.7岁。平均随访时间分别为17.5±8.7个月和17.6±8个月。两组术后视觉模拟评分（P = 0.59）、屈曲（P = 0.68）、外旋（P = 0.42）和加州大学洛杉矶分校评分（P = 0.92）比较。分离RCR组的肩袖撕裂率显著高于分离RCR组（分别为17.7%和35%）；优势比= - 0.19,95%可信区间[- 0.34,- 0.04],P = 0.01)。结论关节镜下手术修复联合骨髓间充质干细胞增强在RCT中比单独手术修复有更好的结构效果。两组患者的疼痛和功能结果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊