Ossendorff Robert, Menon Alessandra, Schildberg Frank A, Randelli Pietro S, Scheidt Sebastian, Burger Christof, Wirtz Dieter C, Cucchi Davide
Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy.
J Clin Med. 2023 Jul 17;12(14):4719. doi: 10.3390/jcm12144719.
The biological enhancement of tissue regeneration and healing is an appealing perspective in orthopedics. We aimed to conduct a systematic review to describe the global distribution of studies investigating the use of adipose tissue derivates in orthopedics and to provide information on their quality and on the products available. The quality of the included studies was assessed using the modified Coleman Methodology Score (mCMS) and the Cochrane risk-of-bias tool for randomized trials. Eighty-two studies were included, with a total of 3594 patients treated. In total, 70% of the studies investigated the treatment of knee disorders, predominantly osteoarthritis; 26% of all studies dealt with expanded adipose-derived stem/stromal cells (ADSCs), 72% of which had stromal vascular fraction (SVF); 70% described the injection of adipose tissue derivates into the affected site; and 24% described arthroscopies with the addition of adipose tissue derivates. The mean mCMS for all studies was 51.7 ± 21.4 points, with a significantly higher score for the studies dealing with expanded ADSCs compared to those dealing with SVF ( = 0.0027). Our analysis shows high heterogeneity in terms of the types of performed procedures as well as the choice and processing of adipose tissue derivates.
组织再生和愈合的生物学增强是骨科领域一个有吸引力的研究方向。我们旨在进行一项系统综述，以描述研究脂肪组织衍生物在骨科应用的全球研究分布情况，并提供有关其质量和可用产品的信息。采用改良的科尔曼方法评分（mCMS）和随机试验的Cochrane偏倚风险工具对纳入研究的质量进行评估。共纳入82项研究，涉及3594例接受治疗的患者。总体而言，70%的研究调查了膝关节疾病的治疗，主要是骨关节炎；所有研究的26%涉及扩增的脂肪来源干细胞（ADSCs），其中72%含有基质血管成分（SVF）；70%描述了将脂肪组织衍生物注射到患病部位；24%描述了在关节镜检查中添加脂肪组织衍生物。所有研究的平均mCMS为51.7±21.4分，与涉及SVF的研究相比，涉及扩增ADSCs的研究得分显著更高（=0.0027）。我们的分析表明，在所进行的手术类型以及脂肪组织衍生物的选择和处理方面存在高度异质性。
