Mesenchymal stem cells in human meniscal regeneration: A systematic review

Abstract

BackgroundStem cell regeneration is the holy grail of meniscal tissue repair. Currently, the best treatment is to preserve the original meniscus but if it fails, a partial meniscectomy is indicated to delay the onset of osteoarthritis.Materials and methodsThe authors present a systematic review to determine the up-to-date evidence underlying the use of mesenchymal stem cells for meniscal regeneration in humans. A search was conducted using the electronic databases of MEDLINE/Pubmed, Google scholar, and the Cochrane Collaboration. Search keywords included human, meniscus, stem cells and regeneration.ResultsAfter screening 10 non-duplicate studies, 5 were identified based on title and abstract. 4 were included in the analysis. There were marked differences in the method of stem cell harvest techniques. 3 studies administered stem cells through percutaneous injection into the knee and 1 study used a collagen scaffold. MRI analysis, functional scores and safety were assessed and the longest follow-up period was 2 years. The Visual Analogue Score (VAS) was most commonly used to assess function and patients generally showed an improvement. There were no reported adverse events.ConclusionDespite positive results from animal models, there is currently a lack of evidence in humans to conclude that stem cells can form durable neotissue similar to original human meniscus. There is a need for standardisation of protocol before further trials are considered. Initial outcomes from human studies are promising and mesenchymal stem cells may play an important role in meniscal repair in years to come.

An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

“…‡ Minimal evidence is available to suggest that stem cell or growth factor therapy is effective, and the optimal route of administration and optimal dosing remain unknown. 21,52,71,91 To our knowledge, this is the first systematic review of systematic reviews and meta-analyses focused on the meniscus. This study is not without limitations.…”

Parathyroid hormone (1-34) promotes the effects of 3D printed scaffold-seeded bone marrow mesenchymal stem cells on meniscus regeneration

“…BMSCs are frequently used as seed cells for tissue-engineered meniscus [10,33]; however, chondrogenesis leads to undesired terminal differentiation of the generated chondrocyte [34,35], which reduces the quality of regenerative tissue and decreases its repair e cacy [30]. In our study, the immunohistochemistry of meniscus implants in BMSCs-scaffold group showed high expression of the chondrocyte terminal differentiation markers Col10 and MMP13, indicating the terminal differentiation of BMSCs.…”

Parathyroid hormone (1-34) promotes the effects of 3D printed scaffold-seeded bone marrow mesenchymal stem cells on meniscus regeneration

“…BMSCs are frequently used as seed cells for tissue-engineered meniscus [ 10 , 33 ]; however, chondrogenesis leads to undesired terminal differentiation of the generated chondrocyte [ 34 , 35 ], which reduces the quality of regenerative tissue and decreases its repair efficacy [ 30 ]. In our study, the immunohistochemistry of meniscus implants in the BMSCs–scaffold group showed high expression of the chondrocyte terminal differentiation markers Col10 and MMP13, indicating the terminal differentiation of BMSCs.…”