A Current Update on Meniscal Scaffolds

Myers, Kevin R.; Sgaglione, Nicholas A.; Kurzweil, Peter

doi:10.1053/j.otsm.2013.03.009

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Thus, it follows that HA helps meniscal healing [11,12]. The presence of glycosaminoglycans also helps with cellular growth [41]. Histologically, Bulgheroni et al (2016) noted that CMI scaffolds had more fibrous tissue and fibroblastic cells with the development of blood vessels [29].…”

Section: Discussionmentioning

confidence: 99%

Are the Biological and Biomechanical Properties of Meniscal Scaffolds Reflected in Clinical Practice? A Systematic Review of the Literature

Ranmuthu

Russell

et al. 2019

IJMS

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The aim of this PRISMA review was to assess whether the CMI and Actifit scaffolds, when used in clinical practice, improve clinical outcomes and demonstrate the ideal biological and biomechanical properties of scaffolds: being chondroprotective, porous, resorbable, able to mature and promote regeneration of tissue. This was done by only including studies that assessed clinical outcome and used a scale to assess both integrity of the scaffold and its effects on articular cartilage via MRI. A search was performed on PubMed, EMBASE, Scopus and clinicaltrials.gov. 2457 articles were screened, from which eight studies were selected: four used Actifit, three used CMI and one compared the two. All studies reported significant improvement in at least one clinical outcome compared to baseline. Some studies suggested that the scaffolds appeared to show porosity, mature, resorb and/or have possible chondroprotective effects, as assessed by MRI. The evidence for clinical translation is limited by differences in study methodology and small sample sizes, but is promising in terms of improving clinical outcomes in the short to mid-term. Higher level evidence, with MRI and histological evaluation of the scaffold and articular cartilage, is now needed to further determine whether these scaffolds exhibit these useful properties.

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Section: Discussionmentioning

confidence: 99%

Are the Biological and Biomechanical Properties of Meniscal Scaffolds Reflected in Clinical Practice? A Systematic Review of the Literature

Ranmuthu

Russell

et al. 2019

IJMS

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“…Both the collagen meniscus implant [ 18 , 19 ] and Actifit® [ 20 ] have been shown to improve pain and functional and radiological outcomes, but approximately one-third of collagen meniscus implant patients do not receive any benefit and improved, well-designed, long-term studies are needed to determine the efficacy and safety of collagen meniscus implantation [ 21 ]. Similarly, a current update on Actifit® notes that while preliminary published data appear promising, there are currently no medium-term or long-term data available for the scaffold [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Meniscus repair using mesenchymal stem cells – a comprehensive review

Adesida

Jomha

2015

Stem Cell Res Ther

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The menisci are a pair of semilunar fibrocartilage structures that play an essential role in maintaining normal knee function. Injury to the menisci can disrupt joint stability and lead to debilitating results. Because natural meniscal healing is limited, an efficient method of repair is necessary. Tissue engineering (TE) combines the principles of life sciences and engineering to restore the unique architecture of the native meniscus. Mesenchymal stem cells (MSCs) have been investigated for their therapeutic potential both in vitro and in vivo. This comprehensive review examines the English literature identified through a database search using Medline, Embase, Engineering Village, and SPORTDiscus. The search results were classified based on MSC type, animal model, and method of MSC delivery/culture. A variety of MSC types, including bone marrow-derived, synovium-derived, adipose-derived, and meniscus-derived MSCs, has been examined. Research results were categorized into and discussed by the different animal models used; namely murine, leporine, porcine, caprine, bovine, ovine, canine, equine, and human models of meniscus defect/repair. Within each animal model, studies were categorized further according to MSC delivery/culture techniques. These techniques included direct application, fibrin glue/gel/clot, intra-articular injection, scaffold, tissue-engineered construct, meniscus tissue, pellets/aggregates, and hydrogel. The purpose of this review is to inform the reader about the current state and advances in meniscus TE using MSCs. Future directions of MSC-based meniscus TE are also suggested to help guide prospective research.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-015-0077-2) contains supplementary material, which is available to authorized users.

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“…Deverá ser previsto no projeto as possíveis alterações de dimensionamento e fixação que ocorrerão no scaffold quando empregado ao corpo humano (8). Por questões de segurança os implantes empregados atualmente são superdimensionados, 10% maiores do que a área mensurada correspondente ao defeito meniscal (35). É aconselhável um dimensionamento maior, pois um tamanho menor irá aumentar a pressão no scaffold fazendo com que seja susceptível a falha8.…”

Section: Resultsunclassified

“…Já, os scaffolds possuem como intuito restaurar as funções do menisco pelo crescimento tissular no interior de sua estrutura (21). Atualmente existem dois tipos de scaffolds empregados em cirurgias: o implante meniscal de colágeno (CMI®, Menaflex) e o implante de poliuretano (Actifit®), ambos são temporários e comercias na Europa para substituição meniscal parcial (lateral e medial) (14,28,(35)(36)(37). Também está em análise clinica o Nusurface® para substituição meniscal medial total (8,9,28).…”

Section: Capítulo 10unclassified