Trivedi Jay, Betensky Daniel, Desai Salomi, Jayasuriya Chathuraka T
Department of Orthopaedics, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, United States.
Front Bioeng Biotechnol. 2021 Dec 22;9:787330. doi: 10.3389/fbioe.2021.787330. eCollection 2021.
Surgical repair of meniscus injury is intended to help alleviate pain, prevent further exacerbation of the injury, restore normal knee function, and inhibit the accelerated development of post-traumatic osteoarthritis (PTOA). Meniscus injuries that are treated poorly or left untreated are reported to significantly increase the risk of PTOA in patients. Current surgical approaches for the treatment of meniscus injuries do not eliminate the risk of accelerated PTOA development. Through recent efforts by scientists to develop innovative and more effective meniscus repair strategies, the use of biologics, allografts, and scaffolds have come into the forefront in pre-clinical investigations. However, gauging the extent to which these (and other) approaches inhibit the development of PTOA in the knee joint is often overlooked, yet an important consideration for determining the overall efficacy of potential treatments. In this review, we catalog recent advancements in pre-clinical therapies for meniscus injuries and discuss the assessment methodologies that are used for gauging the success of these treatments based on their effect on PTOA severity. Methodologies include histopathological evaluation of cartilage, radiographic evaluation of the knee, analysis of knee function, and quantification of OA predictive biomarkers. Lastly, we analyze the prevalence of these methodologies using a systemic PubMed search for original scientific journal articles published in the last 3-years. We indexed 37 meniscus repair/replacement studies conducted in live animal models. Overall, our findings show that approximately 75% of these studies have performed at least one assessment for PTOA following meniscus injury repair. Out of this, 84% studies have reported an improvement in PTOA resulting from treatment.
半月板损伤的手术修复旨在帮助减轻疼痛、防止损伤进一步加重、恢复膝关节正常功能，并抑制创伤后骨关节炎（PTOA）的加速发展。据报道，治疗不当或未治疗的半月板损伤会显著增加患者患PTOA的风险。目前治疗半月板损伤的手术方法并不能消除PTOA加速发展的风险。通过科学家们最近努力开发创新且更有效的半月板修复策略，生物制剂、同种异体移植物和支架的使用已在临床前研究中占据前沿地位。然而，评估这些（以及其他）方法在多大程度上抑制膝关节PTOA的发展常常被忽视，但这是确定潜在治疗方法总体疗效的一个重要考虑因素。在本综述中，我们梳理了半月板损伤临床前治疗的最新进展，并讨论了基于对PTOA严重程度的影响来评估这些治疗方法成功与否的评估方法。这些方法包括软骨的组织病理学评估、膝关节的影像学评估、膝关节功能分析以及OA预测生物标志物的量化。最后，我们通过对过去3年发表的原始科学期刊文章进行系统性的PubMed搜索，分析了这些方法的应用情况。我们检索到在活体动物模型中进行的37项半月板修复/置换研究。总体而言，我们的研究结果表明，这些研究中约75%在半月板损伤修复后至少对PTOA进行了一项评估。其中，84%的研究报告治疗后PTOA有所改善。
