RESEARCH ARTICLE


Meniscal Scaffolds - Preclinical Evidence to Support their Use: A Systematic Review



Berardo Di Matteo*, 1, Francesco Perdisa 1, Natalia Gostynska 1, Elizaveta Kon 2, Giuseppe Filardo 1, Maurilio Marcacci 1
1 II Orthopaedic Clinic and Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano n. 1 40136, Bologna, Italy
2 II Orthopaedic Clinic and Nano-Biotechnology Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano n. 1, 40136, Bologna, Italy


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© Di Matteo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the II Orthopaedic Clinic and Biomechanics Lab., Rizzoli Orthopaedic Institute, Via di Barbiano n. 1/10, 40136, Bologna, Italy; Tel: + 39 0516366567; Fax: +39 051583789; E-mail: berardo.dimatteo@gmail.com


Abstract

Arthroscopic meniscal treatment is the most common procedure performed in the orthopedic practice. Current management of meniscal pathology relies on different therapeutic options, ranging from selective meniscectomy, suturing, and to meniscal replacement by using either allografts or scaffolds. The progresses made in the field of regenerative medicine and biomaterials allowed to develop several meniscal substitutes, some of those currently used in the clinical practice. Before reaching the clinical application, these devices necessarily undergo accurate testing in the animal model: the aim of the present manuscript is to systematically review the scientific evidence derived by animal model results for the use of meniscal scaffolds, in order to understand the current state of research in this particular field and to identify the trends at preclinical level that may influence in the near future the clinical practice.

Thirty-four papers were included in the present analysis. In 12 cases the meniscal scaffolds were used with cells to further stimulate tissue regeneration. With the exception of some negative reports regarding dacron-based scaffolds, the majority of the trials highlighted that biomaterials and bio-engineered scaffolds are safe and could play a beneficial role in stimulating meniscal healing and in chondral protection. With regard to the benefits of cell augmentation, the evidence is limited to a small number of studies and no conclusive evidence is available. However, preclinical evidence seems to suggest that cells could enhance tissue regeneration with respect to the use of biomaterials alone, and further research should confirm the translational potential of cell-based approach.

Keywords: Biomaterials, knee, meniscal scaffold, meniscus, animal model, regenerative medicine.