Filardo Giuseppe, Andriolo Luca, Kon Elizaveta, de Caro Francesca, Marcacci Maurilio
II Clinic - Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy,
Int Orthop. 2015 Jan;39(1):35-46. doi: 10.1007/s00264-014-2415-x. Epub 2014 Jun 29.
The aim of this systematic review was to document the available clinical evidence to support meniscal scaffold implantation, analysing results and indications for the treatment of meniscal loss.
The systematic review of the literature was performed searching three medical electronic databases: PubMed, Scopus, and the Cochrane Collaboration. The guidelines for preferred reporting items for systematic reviews and meta-analysis (PRISMA) were used. Relevant data were then extracted and collected in a unique database with consensus of two observers. To assess the methodological quality of the collected data, the subscales of a modified Coleman methodology score (CMS) were determined.
A total of 23 studies on two scaffolds (CMI, Ivy Sports Medicine GmbH, Germany; Actifit, Orteq, United Kingdom) met the inclusion criteria and were used for the final analysis, of which more than half have been published in the last three years. Good clinical results have been documented in 613 patients, mainly young men affected by symptomatic chronic lesions, with a cumulative failure rate of 6.1% and presence of newly formed tissue documented both at histological and MRI evaluation in most cases. However, there is a lack of comparative trials and the average study quality is low.
An increase in publications regarding this topic has been seen recently, due to the introduction in the clinical practice of the second synthetic scaffold. Safety and positive results have been shown for both scaffolds. Although, literature lacks randomized trials at long-term follow-up to confirm real potential and most appropriate indications of meniscal scaffold implantation.
本系统评价的目的是记录支持半月板支架植入的现有临床证据，分析半月板损伤治疗的结果和适应证。
通过检索三个医学电子数据库进行文献系统评价：PubMed、Scopus和Cochrane协作网。采用系统评价和Meta分析的首选报告项目指南（PRISMA）。然后在两名观察者达成共识的情况下，将相关数据提取并收集到一个单独的数据库中。为评估所收集数据的方法学质量，确定了改良的科尔曼方法评分（CMS）的子量表。
共有23项关于两种支架（德国Ivy Sports Medicine GmbH公司的CMI；英国Orteq公司的Actifit）的研究符合纳入标准并用于最终分析，其中一半以上是在过去三年发表的。613例患者取得了良好的临床结果，主要是患有症状性慢性损伤的年轻男性，累积失败率为6.1%，在大多数病例的组织学和MRI评估中均记录到有新形成的组织。然而，缺乏对照试验，且平均研究质量较低。
由于第二种合成支架引入临床实践，最近关于该主题的出版物有所增加。两种支架均显示出安全性和阳性结果。尽管如此，文献中缺乏长期随访的随机试验来证实半月板支架植入的真正潜力和最合适的适应证。
