Potential use of mesenchymal stem cells in human meniscal repair: current insights

Pak, Jaewoo; Lee, Jung Hun; Park, Kwang Seung; Jeon, Jeong Ho; Lee, Sangeun

doi:10.2147/oajsm.s113018

Cited by 20 publications

(13 citation statements)

References 41 publications

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“…Patients showed significant improvements in pain at 3 months and complications were limited to localized pain and swelling or tenosynovitis. A subsequent review by the same group reported that 32 of patients who had evidence of meniscal tears also demonstrated significant improvements in pain and function . They also reported on a 2014 case study in which a 32‐year‐old woman with a grade 2 medial meniscal tear in the posterior horn was injected with a similar combination of ASCs, PRP, hyaluronic acid, and calcium chloride, with 4 additional doses of PRP with calcium chloride and hyaluronic acid at days 3, 7, 14, and 28.…”

Section: Addressing the Treatment Gap—orthobiologicsmentioning

confidence: 98%

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

Chirichella

Jow

Iacono

et al. 2019

PM&R

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The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted because the recent literature has supported the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision. Choosing an appropriate management strategy depends on multiple factors such as patient demographics and location of the tear. Physical therapy remains a first-line treatment for knee pain secondary to meniscus tear and should be pursued in the setting of acute and chronic knee pain. Furthermore, there is a growing amount of evidence showing that elderly patients with complex meniscus tears in the setting of degenerative arthritis should not undergo arthroscopic surgery. Direct meniscus repair remains an option in ideal patients who are young, healthy, and have tears near the more vascular periphery of the meniscus but it is not suitable for all patients. Use of orthobiologics such as platelet-rich plasma and mesenchymal stem cells have shown promise in augmenting surgical repairs or as standalone treatments, although research for their use in meniscal tear management is limited.

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Section: Addressing the Treatment Gap—orthobiologicsmentioning

confidence: 98%

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

Chirichella

Jow

Iacono

et al. 2019

PM&R

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“…In vitro and in vivo studies of clonally derived MSCs demonstrated that these cells consist of subsets that present different surface markers expression and different capacities for cellular differentiation [42]. These cells are considered a potential cell source for cell therapy since they can be easily collected from various tissues such as bone marrow [43], adipose tissue [44], synovial membrane [42], and amniotic membrane [45], among others. However, the equivalence of chondrogenic differentiation potential of MSCs derived from different tissues is a matter of considerable debate [46].…”

Section: Mesenchymal Stromal Cellsmentioning

confidence: 99%

Cell Therapy and Tissue Engineering for Cartilage Repair

Piñeiro-Ramil¹,

Castro-Viñuelas²,

Rodríguez³

et al. 2018

Cartilage Repair and Regeneration

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The integrity of the articular cartilage is necessary for the proper functioning of the diarthrodial joint. The self-repair capacity of this tissue is very limited and, currently, there is no effective treatment capable of restoring it. The degradation of the articular cartilage leads to osteoarthritis (OA), a leading cause of pain and disability mainly among older people.Different cell treatments have been developed with the aim of forming a repair tissue with the characteristics of native articular cartilage, including cellular therapy and tissue engineering. Cell therapy-based approaches include bone marrow-stimulating techniques, implants of periosteum and perichondrium, ostechondral grafting and implantation of chondrogenic cells as chondrocytes, mesenchymal stem cells or induced pluripotent stem cells. In tissue engineering-based approaches cell-free scaffolds capable of recruiting endogenous cells or chondrogenic cell-loaded scaffolds may be used.However, despite the numerous treatments available nowadays, no technique has been able to consistently regenerate native articular cartilage in clinical trials. Although many cell therapy and tissue engineering studies have shown promising results and clinical improvement, these treatments generate a fibrocartilaginous tissue different from native articular cartilage. More research is needed to improve cell-based approaches and prove its efficacy

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“…Successful repair strategies for lesions in the vascular zone of the meniscus like suturing have already been developed [ 17 , 18 ]. However, up to now, there is still no established curative therapy for lesions within the avascular parts of the meniscus in clinical practice [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to the current literature, mesenchymal stromal cells (MSC) are the focus of attention in newly developed approaches for meniscus repair [ 2 , 21 – 27 ]. As these cells have both the potential to differentiate into fibrochondrocytes and the ability to secrete repair-promoting growth factors, they seem to be an ideal tool for meniscus repair [ 22 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Tissue Engineering of Large Full-Size Meniscus Defects by a Polyurethane Scaffold: Accelerated Regeneration by Mesenchymal Stromal Cells

Koch

Achatz

Lang

et al. 2018

Stem Cells International

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The endogenous healing potential of avascular meniscal lesions is poor. Up to now, partial meniscectomy is still the treatment of choice for meniscal lesions within the avascular area. However, the large loss of meniscus substance predisposes the knee for osteoarthritic changes. Tissue engineering techniques for the replacement of such lesions could be a promising alternative treatment option. Thus, a polyurethane scaffold, which is already in clinical use, loaded with mesenchymal stromal cells, was analyzed for the repair of critical meniscus defects in the avascular zone. Large, approximately 7 mm broad meniscus lesions affecting both the avascular and vascular area of the lateral rabbit meniscus were treated with polyurethane scaffolds either loaded or unloaded with mesenchymal stromal cells. Menisci were harvested at 6 and 12 weeks after initial surgery. Both cell-free and cell-loaded approaches led to well-integrated and stable meniscus-like repair tissue. However, an accelerated healing was achieved by the application of mesenchymal stromal cells. Dense vascularization was detected throughout the repair tissue of both treatment groups. Overall, the polyurethane scaffold seems to promote the vessel ingrowth. The application of mesenchymal stromal cells has the potential to speed up the healing process.

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Potential use of mesenchymal stem cells in human meniscal repair: current insights

Cited by 20 publications

References 41 publications

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

Cell Therapy and Tissue Engineering for Cartilage Repair

Tissue Engineering of Large Full-Size Meniscus Defects by a Polyurethane Scaffold: Accelerated Regeneration by Mesenchymal Stromal Cells

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