Biochemical Characteristics and Clinical Result of Bone Marrow–Derived Fibrin Clot for Repair of Isolated Meniscal Injury in the Avascular Zone

Hashimoto, Yusuke; Nishino, Kazuya; Orita, Kumi; Yamasaki, Shinya; Nishida, Yohei; Kinoshita, Takuya; Nakamura, Hiroaki

doi:10.1016/j.arthro.2021.05.026

Cited by 16 publications

(11 citation statements)

References 44 publications

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“…Fortier et al reported that delivery of concentrated BMA can result in the healing of acute full-thickness cartilage defects, which is superior to that after microfracture alone in an equine model [ 19 ]. Hashimoto et al reported an improvement in postoperative clinical results after meniscal repair using a BMA clot for isolated avascular meniscal injury [ 14 ]. Given these advantages of a BMA, it is expected to promote the transformation of a tendon into meniscus-like tissue more effectively.…”

Section: Discussionmentioning

confidence: 99%

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The Potential of Using an Autogenous Tendon Graft by Injecting Bone Marrow Aspirate in a Rabbit Meniscectomy Model

Iida

Hashimoto²,

Orita³

et al. 2022

IJMS

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Bone marrow aspirate (BMA) is an excellent source of cells and growth factors and has been used successfully for bone, cartilage, and soft-tissue healing. This study aimed to investigate the histological and biomechanical properties of autogenous tendon graft by injecting BMA and its protective effect against degenerative changes in a rabbit model of meniscal defects. Adult white rabbits were divided into untreated, tendon, and tendon + BMA groups, and meniscal defects were created in the knees. The tendon graft and articular cartilage status were evaluated by macroscopic and histological analysis at 4, 12, and 24 weeks postoperatively among the three groups. The tendon graft in the tendon and tendon + BMA groups were used for biomechanical evaluation at 4, 12, and 24 weeks postoperatively. The meniscal covering ratio in the tendon + BMA group was better than that in the tendon and untreated groups at 12 and 24 weeks postoperatively. The matrix around the central portion of cells in the tendon + BMA group was positively stained by safranin O and toluidine blue staining with metachromasia at 24 weeks. The histological score of the tendon graft in the tendon + BMA group was significantly higher than that in the untreated and tendon groups at 12 and 24 weeks postoperatively. In the tendon + BMA group, cartilage erosion was not shown at 4 weeks, developed slowly, and was better preserved at 12 and 24 weeks compared to the untreated and tendon groups. Histological scores for the articular cartilage were significantly better in the tendon + BMA group at 24 weeks. The compressive stress on the tendon graft in the tendon + BMA group was significantly higher than that in the tendon group at 12 weeks postoperatively. Transplantation of autogenous tendon grafts by injecting BMA improved the histologic score of the regenerated meniscal tissue and was more effective than the tendon and untreated group for preventing cartilage degeneration in a rabbit model of massive meniscal defects.

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Section: Discussionmentioning

confidence: 99%

“…Liang et al reported that bFGF and TGF-b maintained chondrogenesis of semilunar fibrochondrocytes under hypoxic conditions [ 13 ]. Moreover, the BMA fibrin clot is expected to enhance the meniscal healing of avascular tears [ 14 ]. Given these advantages, BMA may effectively promote tendon transformation into meniscus-like tissue.…”

Section: Introductionmentioning

confidence: 99%

The Potential of Using an Autogenous Tendon Graft by Injecting Bone Marrow Aspirate in a Rabbit Meniscectomy Model

Iida

Hashimoto²,

Orita³

et al. 2022

IJMS

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“…Similar to peripheral blood-derived fibrin clots, BMA clots are easily prepared from BMA and had significantly higher levels of cytokines compared to peripheral blood-derived clots from the intercondylar notch of the knee joint, and the rates of clinical failure following meniscal repair with a BMA clot for isolated avascular meniscal injury were 10%. 8 Thus, BMA clots obtained from the knee may be a superior adjuvant in promoting healing of the meniscal tissue compared to peripheral blood clots. Inside-out repair is a gold standard and cost-effective technique that allows anatomical reduction of the torn meniscus.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Repair for Parrot Beak Tear of Lateral Meniscus with Reduction Suture and Inside-Out Technique

Hashimoto

Takigami

Tomihara

et al. 2021

Arthroscopy Techniques

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“…Also, Perkins et al 36 applied both inside-out and all-inside techniques in their study. Patients in the meniscus with ACL injury group underwent ACLR surgery and meniscus suturing; only 3 reported the suture techniques, 34,35,40 2 with inside-out technique, 35,41 and 1 with outside-in technique. 34 Four used semitendinosus and gracilis hamstring tendons for ACLR, 18,28,34,35 2 used bone-patellar tendon-bone, 37,42 and 2 used hamstring for reconstruction.…”

Section: Characteristics Of Surgical Techniques In Both Groupsmentioning

confidence: 99%

“…26,40 There were 4 studies who reported the usage of double bundles in ACLR. 18,35,37,41 Cristiani et al 37 divided patients into patellar group and hamstring group, and compared the effectiveness of different grafts.…”

Section: Characteristics Of Surgical Techniques In Both Groupsmentioning

confidence: 99%

Does Accelerated Rehabilitation Provide Better Outcomes Than Restricted Rehabilitation in Postarthroscopic Repair of Meniscal Injury?

You

Wang

Huang

et al. 2023

Journal of Sport Rehabilitation

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Context: Meniscal injury is a common pathology, and the postoperative rehabilitation program is essential to patients after surgery. However, the optimal rehabilitation plan after meniscus suture is still controversial. Objective: To compare the clinical outcomes between accelerated rehabilitation and restricted programs in patients with meniscus suture (with or without anterior cruciate ligament reconstruction, ACLR). Evidence Acquisition: Four databases, including PubMed, Ovid, Embase, and the Cochrane Library, were searched up to November 2021. This study only included studies comparing the clinical outcomes between accelerated (immediate range of motion and weight-bearing) and restricted rehabilitation (immobilization and progressive weight-bearing) for meniscus suture. All selected studies were divided into 2 subgroups: isolated meniscus suture or combined with ACLR. The Lysholm score, Tegner score, and Knee Injury and Osteoarthritis Outcome Score were evaluated in simple meniscus sutures no less than 1 year. Failure rate was evaluated in both groups, and the tunnel enlargement was additionally evaluated in patients who underwent ACLR. Evidence Synthesis: Eleven studies with 612 patients were eligible for analysis. The accelerated group included 4 studies with 330 participants, while the restricted group included 7 studies with 282 participants. For the patients after isolated meniscus suture, the accelerated group achieved higher Lysholm scores (mean difference = −4.66; 95% confidence interval, −8.6 to −0.73; P = .02; I2 = 88%) than the restricted group. For the patients after meniscus suture with ACLR, patients undergoing accelerated rehabilitation were associated with a significantly larger tibial tunnel enlargement in the anterior–posterior view (mean difference = −7.08; 95% confidence interval, −10.92 to −3.24; P = .0003; I2 = 0%) and lateral view (mean difference = −10.33; 95% confidence interval, −16.9 to −3.75; P = .002; I2 = 17%). Conclusion: This meta-analysis evaluated the effects of postoperative rehabilitation in either accelerated or restricted programs in patients with meniscus lesions after repair. A significant higher mean self-reported function was discovered at final follow-ups in the accelerated group. However, a significant increase in tibial tunnel enlargement was also found in accelerated group.

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Biochemical Characteristics and Clinical Result of Bone Marrow–Derived Fibrin Clot for Repair of Isolated Meniscal Injury in the Avascular Zone

Cited by 16 publications

References 44 publications

The Potential of Using an Autogenous Tendon Graft by Injecting Bone Marrow Aspirate in a Rabbit Meniscectomy Model

The Potential of Using an Autogenous Tendon Graft by Injecting Bone Marrow Aspirate in a Rabbit Meniscectomy Model

Arthroscopic Repair for Parrot Beak Tear of Lateral Meniscus with Reduction Suture and Inside-Out Technique

Does Accelerated Rehabilitation Provide Better Outcomes Than Restricted Rehabilitation in Postarthroscopic Repair of Meniscal Injury?

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