Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
Department of Orthopaedic Surgery, Auguste-Viktoria Clinic, Ruhr University Bochum, 32545, Bad Oeynhausen, Germany.
J Orthop Surg Res. 2022 Jun 11;17(1):308. doi: 10.1186/s13018-022-03203-4.
This systematic review investigated the efficacy and safety of surgical procedures augmented with cell therapies for chondral defects of the talus.
The present systematic review was conducted according to the 2020 PRISMA guidelines. PubMed, Google scholar, Embase, and Scopus databases were accessed in March 2022. All the clinical trials investigating surgical procedures for talar chondral defects augmented with cell therapies were accessed. The outcomes of interest were to investigate whether surgical procedures augmented with cell therapies promoted improvement in patients reported outcomes measures (PROMs) with a tolerable rate of complications.
Data from 477 procedures were retrieved. At a mean follow-up of 34.8 ± 9.7 months, the Visual Analogic Scale (VAS) improved of 4.4/10 (P = 0.002) and the American Orthopaedic Foot and Ankle Score (AOFAS) of 31.1/100 (P = 0.0001) points. No improvement was found in Tegner score (P = 0.4). Few articles reported data on complications. At last follow-up, the rate of reoperation and failure were 0.06% and 0.03%, respectively. No graft delamination or hypertrophy was observed.
The current evidence suggests that cell therapies may be effective and safe to enhance surgical procedures for chondral defects of the talus. These results should be considered within the limitations of the present study. The current literature should be enriched with randomized controlled clinical trials with larger population size and longer follow-up.
本系统评价研究了细胞疗法增强的手术程序治疗距骨软骨缺损的疗效和安全性。
本系统评价根据 2020 年 PRISMA 指南进行。2022 年 3 月检索了 PubMed、Google Scholar、Embase 和 Scopus 数据库，以获取所有研究细胞疗法增强的手术程序治疗距骨软骨缺损的临床试验。感兴趣的结果是调查细胞疗法增强的手术程序是否能提高患者报告的结局测量（PROMs），且并发症发生率可接受。
共检索到 477 例手术的数据。平均随访 34.8±9.7 个月后，视觉模拟评分（VAS）改善了 4.4/10（P=0.002），美国矫形足踝协会评分（AOFAS）改善了 31.1/100（P=0.0001）分。Tegner 评分无改善（P=0.4）。少数文章报告了并发症数据。末次随访时，再次手术率和失败率分别为 0.06%和 0.03%。未观察到移植物分层或肥大。
目前的证据表明，细胞疗法可能对增强距骨软骨缺损的手术程序有效且安全。这些结果应在本研究的局限性内考虑。目前的文献应该通过更大的人群规模和更长的随访时间来丰富随机对照临床试验。
