School of Clinical Medicine, Addenbrooke's Hospital, University Of Cambridge, Cambridge CB2 0SP, UK.
Division of Trauma & Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, UK.
Int J Mol Sci. 2019 Feb 1;20(3):632. doi: 10.3390/ijms20030632.
The aim of this PRISMA review was to assess whether the CMI and Actifit scaffolds, when used in clinical practice, improve clinical outcomes and demonstrate the ideal biological and biomechanical properties of scaffolds: being chondroprotective, porous, resorbable, able to mature and promote regeneration of tissue. This was done by only including studies that assessed clinical outcome and used a scale to assess both integrity of the scaffold and its effects on articular cartilage via MRI. A search was performed on PubMed, EMBASE, Scopus and clinicaltrials.gov. 2457 articles were screened, from which eight studies were selected: four used Actifit, three used CMI and one compared the two. All studies reported significant improvement in at least one clinical outcome compared to baseline. Some studies suggested that the scaffolds appeared to show porosity, mature, resorb and/or have possible chondroprotective effects, as assessed by MRI. The evidence for clinical translation is limited by differences in study methodology and small sample sizes, but is promising in terms of improving clinical outcomes in the short to mid-term. Higher level evidence, with MRI and histological evaluation of the scaffold and articular cartilage, is now needed to further determine whether these scaffolds exhibit these useful properties.
本次 PRISMA 综述的目的是评估 CMI 和 Actifit 支架在临床实践中是否能改善临床结果，并展示支架理想的生物学和生物力学特性：具有软骨保护作用、多孔性、可吸收性、能够成熟并促进组织再生。这是通过仅纳入评估临床结果并使用 MRI 评估支架完整性及其对关节软骨影响的评分标准的研究来实现的。在 PubMed、EMBASE、Scopus 和 clinicaltrials.gov 上进行了检索。共筛选了 2457 篇文章，其中有 8 项研究入选：4 项使用 Actifit，3 项使用 CMI，1 项比较了两者。与基线相比，所有研究报告至少有一项临床结果显著改善。一些研究表明，支架在 MRI 评估时显示出多孔性、成熟、吸收和/或具有潜在的软骨保护作用。由于研究方法和样本量小的差异，临床转化的证据有限，但在短期至中期改善临床结果方面有很大的希望。现在需要更高水平的证据，包括对支架和关节软骨的 MRI 和组织学评估，以进一步确定这些支架是否具有这些有用的特性。
