Loppini Mattia, Longo Umile Giuseppe, Niccoli Giuseppe, Khan Wasim S, Maffulli Nicola, Denaro Vincenzo
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy.
Curr Stem Cell Res Ther. 2015;10(1):43-55. doi: 10.2174/1574888x09666140710110723.
This systematic review analyzes histological scoring systems for degenerative tendon-enthesis changes, ex vivo tendon-enthesis repair and tissue-engineered tendon-enthesis repair. A secondary aim is to establish the validity and applicability of these scores to find a comprehensive and validated histological scoring system for the evaluation of tendon-enthesis tissue.
We performed a systematic review of the literature by analyzing the following databases: PubMed, Embase, Medline, CINAHL, and Cochrane. The methodology of the study was developed according to the PRISMA guidelines.
Twenty-seven articles, describing a total of 9 scores for tendinopathy, 6 scores for tendon ruptures, and 12 scores for tendon regeneration were included. For enthesis changes, 4 studies describe a total of 3 scores for enthesopathy and 1 scores for enthesis regeneration. The Movin score and its modifications seem be the more comprehensive to assess the degenerative changes; the Soslowsky score, the Watkins score, the Novel scoring system and the Burssens score seem be the more comprehensive to assess tendon repair process. Only the Matthys score assesses the histological changes in enthesopathies, and the modified Watkins score has been well applied to assess enthesis repair.
The assessment of tendon-enthesis structure can be performed with several histological scoring systems previously published in literature. However, no studies have been performed to validate these score in research settings. Further experimental and clinical studies should be developed to provide a comprehensive and validated scoring system for the histological assessment of tendon-enthesis repair.
本系统评价分析了用于评估退行性肌腱-附着点改变、离体肌腱-附着点修复及组织工程化肌腱-附着点修复的组织学评分系统。次要目的是确定这些评分系统的有效性和适用性，以找到一个全面且经过验证的用于评估肌腱-附着点组织的组织学评分系统。
我们通过分析以下数据库对文献进行了系统评价：PubMed、Embase、Medline、CINAHL和Cochrane。研究方法根据PRISMA指南制定。
纳入了27篇文章，共描述了9种用于肌腱病的评分、6种用于肌腱断裂的评分以及12种用于肌腱再生的评分。对于附着点改变，4项研究共描述了3种用于附着点病的评分和1种用于附着点再生的评分。Movin评分及其改良版似乎在评估退行性改变方面更为全面；Soslowsky评分、Watkins评分、新型评分系统和Burssens评分似乎在评估肌腱修复过程方面更为全面。只有Matthys评分用于评估附着点病的组织学改变，改良的Watkins评分已被很好地应用于评估附着点修复。
肌腱-附着点结构的评估可以使用先前文献中发表的几种组织学评分系统进行。然而，尚未有研究在研究环境中对这些评分进行验证。应开展进一步的实验和临床研究，以提供一个全面且经过验证的评分系统，用于肌腱-附着点修复的组织学评估。
