Clinical application of polyurethane meniscal scaffold: A meta-analysis

Li, Wei; Pan, Jinhe; Li, Jintao; Guo, Jinshan; Zeng, Chun; Xie, Denghui

doi:10.1016/j.jor.2021.02.027

Cited by 3 publications

(6 citation statements)

References 31 publications

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“…Following the screening process, 58 studies were identified as focusing on meniscal allograft transplantation or meniscal scaffold‐based approaches. Among the 58 studies, 41 were excluded for focusing on meniscal allograft transplantation, resulting in 17 studies included in this umbrella review (Figure 1 ) [ 4 , 7 , 9 , 10 , 11 , 13 , 15 , 19 , 20 , 21 , 25 , 26 , 27 , 29 , 31 , 32 , 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…On average, these reviews included 15.7 studies, with a predominant focus on retrospective cohort studies (Table 3 ). The majority of reviews included studies that predominantly involved male participants, ranging from 60% to 80% [ 7 , 9 , 11 , 13 , 15 , 19 , 21 , 32 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies (70.6%) included patient‐reported outcome measures (PROMs), with the Lysholm score being the most commonly reported ( n = 12; 70.6%), followed by the Tegner activity scale ( n = 12; 70.6%), VAS for pain ( n = 12; 70.6%), IKDC score ( n = 8; 47.1%) and the KOOS ( n = 6; 35.3%) [ 4 , 7 , 9 , 11 , 13 , 15 , 19 , 20 , 21 , 25 , 27 , 32 ]. All reviews that reported on PROMs noted postoperative improvements compared to baseline, although many studies included concomitant procedures.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies examined the radiographic impact of using these scaffold implants. Li and colleagues examined polyurethane‐based scaffolds and concluded that while PROMs improved, there was a morphological deterioration of the implant seen on MRI at the most recent follow‐up in the studies included [ 15 ]. They were unable to conclude whether that deterioration was clinically relevant.…”

Section: Resultsmentioning

confidence: 99%

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Addressing meniscal deficiency part 2: An umbrella review of systematic reviews and meta‐analyses on meniscal scaffold‐based approaches

Wu,

Therien,

Kiwinda

et al. 2024

J. exp. orthop.

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PurposeMeniscal injuries are common in knee surgery and often require preservation techniques to prevent secondary osteoarthritis. Despite advancements in repair techniques, some patients undergo partial meniscectomy, which can lead to postmeniscectomy syndrome. To address these challenges, meniscal substitution techniques like scaffolds have been developed. However, a comprehensive synthesis of the existing evidence through an umbrella review is lacking.MethodsA comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta‐analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of included studies was assessed using the AMSTAR‐2 tool.ResultsA total of 17 studies met the inclusion criteria and were included in the review. Most studies focused on the use of collagen‐based scaffolds, with fewer studies evaluating synthetic scaffolds. The majority of studies (52.9%) were rated as having ‘Critically Low’ overall confidence, with only one study (5.9%) rated as ‘High’ confidence and most studies exhibiting methodological limitations, such as small sample sizes and lack of long‐term follow‐up. Despite these limitations, the majority of studies reported positive short‐term outcomes, including pain relief and functional improvement, following scaffold implantation. However, some studies noted a relatively high failure rate. Radiographically, outcomes also varied, with some studies reporting morphological deterioration of the implant seen on MRI, while others noted possible chondroprotective effects.ConclusionsMeniscal scaffold‐based approaches show promise in the management of meniscal deficiency; however, the current evidence is limited by methodological shortcomings. One notable gap in the literature is the lack of clear guidelines for patient selection and surgical technique. Future research should focus on conducting well‐designed randomized controlled trials with long‐term follow‐up to further elucidate the benefits and indications of these techniques in clinical practice. Additionally, efforts should be made to develop consensus guidelines to standardize the use of meniscal scaffolds and improve patient outcomes. Despite limited availability, synthesizing the literature on meniscal scaffold‐based approaches is crucial for understanding research, guiding clinical decisions and informing future directions.Level of EvidenceLevel IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Addressing meniscal deficiency part 2: An umbrella review of systematic reviews and meta‐analyses on meniscal scaffold‐based approaches

Wu,

Therien,

Kiwinda

et al. 2024

J. exp. orthop.

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“…On the other hand, irreparable meniscal tear treatment performed using partial meniscectomy, which significantly increases peak contact pressure across the tibiofemoral joint compartment, reportedly leads to degenerative changes and osteoarthritis [9,10]. To resolve this issue, meniscal scaffolds have been developed [11][12][13][14] and are indicated for irreparable meniscal tears to preserve the meniscal size and function [15,16].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Probing Sensor Device for Evaluating Meniscal Suture and Scaffold Implantation

Sezaki,

Otsuki,

Ishitani

et al. 2024

Biomimetics

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Appropriate suture tension is a key factor in successful meniscal repair. This study aimed to clarify the appropriate value of meniscal stabilization with suture repair based on a probing procedure for healthy porcine menisci and a novel meniscal scaffold. After evaluating the reliability of the probing sensor, meniscal vertical tear and partial meniscectomy models were developed, in which suture repair and meniscal scaffold implantation were performed at suture intervals ranging between 20 and 2.5 mm. The residence forces at each interval were evaluated using a probing sensor. Moreover, a tensile test was conducted to evaluate the displacement and presence or absence of gaps. We found that normal and meniscal scaffolds should be fixed within 5 mm of suture interval. The probing residence forces required were at least 1.0 N for vertical tears and 3.0 N for meniscal scaffolds. These findings may be taken into consideration to reduce suture failure following meniscal tear repair and stabilizing meniscal scaffold fixation.

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Clinical Outcomes After Polyurethane Meniscal Scaffolds Implantation Remain Stable Despite a Joint Space Narrowing at 10-Year Follow-Up

Torres-Claramunt,

Alós-Mairal,

Ibáñez

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Clinical application of polyurethane meniscal scaffold: A meta-analysis

Cited by 3 publications

References 31 publications

Addressing meniscal deficiency part 2: An umbrella review of systematic reviews and meta‐analyses on meniscal scaffold‐based approaches

Addressing meniscal deficiency part 2: An umbrella review of systematic reviews and meta‐analyses on meniscal scaffold‐based approaches

Usefulness of Probing Sensor Device for Evaluating Meniscal Suture and Scaffold Implantation

Clinical Outcomes After Polyurethane Meniscal Scaffolds Implantation Remain Stable Despite a Joint Space Narrowing at 10-Year Follow-Up

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