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Partovi A, Khedrinia M, Arjmand S, Ranaei Siadat SO. Electrospun nanofibrous wound dressings with enhanced efficiency through carbon quantum dots and citrate incorporation. Sci Rep 2024; 14:19256. [PMID: 39164352 PMCID: PMC11336181 DOI: 10.1038/s41598-024-70295-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/14/2024] [Indexed: 08/22/2024] Open
Abstract
Nanofibers show promise for wound healing by facilitating active agent delivery, moisture retention, and tissue regeneration. However, selecting suitable dressings for diverse wound types and managing varying exudate levels remains challenging. This study synthesized carbon quantum dots (CQDs) from citrate salt and thiourea using a hydrothermal method. The CQDs displayed antibacterial activity against Staphylococcus aureus and Escherichia coli. A nanoscaffold comprising gelatin, chitosan, and polycaprolactone (GCP) was synthesized and enhanced with silver nanoparticle-coated CQDs (Ag-CQDs) to form GCP-Q, while citrate addition yielded GCP-QC. Multiple analytical techniques, including electron microscopy, FT-IR spectroscopy, dynamic light scattering, UV-Vis, photoluminescence, X-ray diffraction, porosity, degradability, contact angle, and histopathology assessments characterized the CQDs and nanofibers. Integration of CQDs and citrate into the GCP nanofibers increased porosity, hydrophilicity, and degradability-properties favorable for wound healing. Hematoxylin and eosin staining showed accelerated wound closure with GCP-Q and GCP-QC compared to GCP alone. Overall, GCP-Q and GCP-QC nanofibers exhibit significant potential for skin tissue engineering applications.
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Affiliation(s)
- Alireza Partovi
- Protein Research Center, Shahid Beheshti University, Tehran, Iran
- AryaTinaGene Biopharmaceutical Company, Gorgan, Iran
| | - Mostafa Khedrinia
- Department of Biology, Faculty of Science, Golestan University, Gorgan, Iran
- AryaTinaGene Biopharmaceutical Company, Gorgan, Iran
| | - Sareh Arjmand
- Protein Research Center, Shahid Beheshti University, Tehran, Iran.
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Li X, Li D, Li J, Wang G, Yan L, Liu H, Jiu J, Li JJ, Wang B. Preclinical Studies and Clinical Trials on Cell-Based Treatments for Meniscus Regeneration. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:634-670. [PMID: 37212339 DOI: 10.1089/ten.teb.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study aims at performing a thorough review of cell-based treatment strategies for meniscus regeneration in preclinical and clinical studies. The PubMed, Embase, and Web of Science databases were searched for relevant studies (both preclinical and clinical) published from the time of database construction to December 2022. Data related to cell-based therapies for in situ regeneration of the meniscus were extracted independently by two researchers. Assessment of risk of bias was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Statistical analyses based on the classification of different treatment strategies were performed. A total of 5730 articles were retrieved, of which 72 preclinical studies and 6 clinical studies were included in this review. Mesenchymal stem cells (MSCs), especially bone marrow MSCs (BMSCs), were the most commonly used cell type. Among preclinical studies, rabbit was the most commonly used animal species, partial meniscectomy was the most commonly adopted injury pattern, and 12 weeks was the most frequently chosen final time point for assessing repair outcomes. A range of natural and synthetic materials were used to aid cell delivery as scaffolds, hydrogels, or other morphologies. In clinical trials, there was large variation in the dose of cells, ranging from 16 × 106 to 150 × 106 cells with an average of 41.52 × 106 cells. The selection of treatment strategy for meniscus repair should be based on the nature of the injury. Cell-based therapies incorporating various "combination" strategies such as co-culture, composite materials, and extra stimulation may offer greater promise than single strategies for effective meniscal tissue regeneration, restoring natural meniscal anisotropy, and eventually achieving clinical translation. Impact Statement This review provides an up-to-date and comprehensive overview of preclinical and clinical studies that tested cell-based treatments for meniscus regeneration. It presents novel perspectives on studies published in the past 30 years, giving consideration to the cell sources and dose selection, delivery methods, extra stimulation, animal models and injury patterns, timing of outcome assessment, and histological and biomechanical outcomes, as well as a summary of findings for individual studies. These unique insights will help to shape future research on the repair of meniscus lesions and inform the clinical translation of new cell-based tissue engineering strategies.
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Affiliation(s)
- Xiaoke Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Dijun Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Jiarong Li
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, Australia
| | - Guishan Wang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, China
| | - Lei Yan
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Haifeng Liu
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Jingwei Jiu
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Jiao Jiao Li
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, Australia
| | - Bin Wang
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Yang Z, Fan Z, Wang D, Li H, He Z, Xing D, Lin J. Bibliometric and visualization analysis of stem cell therapy for meniscal regeneration from 2012 to 2022. Front Bioeng Biotechnol 2023; 11:1107209. [PMID: 36865032 PMCID: PMC9971621 DOI: 10.3389/fbioe.2023.1107209] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
Background: Meniscus injuries, a common joint disease caused by long-term wear, trauma and inflammation, usually cause chronic dysfunction and pain in the joint. Current clinical surgeries mainly aim to remove the diseased tissue to alleviate patient suffering instead of helping with meniscus regeneration. As an emerging treatment, stem cell therapy has been verified to facilitate meniscus regeneration effectively. The purpose of this study is to investigate the publication conditions of stem cell therapy for meniscal regeneration and to visualize the research trends and frontiers. Methods: Relevant publications relevant to stem cells for meniscal regeneration was retrieved SCI-Expanded of the Web of Science database from 2012 to 2022. Research trends in the field were analysed and visualized by CiteSpace and VOSviewer. Results: A total of 354 publications were collected and analysed. The United States contributed the largest number of publications (118, 34.104%). Tokyo Medical Dental University has contributed the largest number of publications (34) among all full-time institutions. Stem cell research therapy has published the largest number of researches on stem cells for meniscal regeneration (17). SEKIYA. I contributed the majority of publications in this field (31), while Horie, M was the most frequently cited authors (166). #1 tissue engineering, #2 articular cartilage, #3 anterior cruciate ligament, #4 regenerative medicine, #5 scaffold are the chief keywords. This indicates that the current research hotspot has been transformed from basic surgical research to tissue engineering. Conclusion: Stem cell therapy is a promising therapeutic method for meniscus regeneration. This is the first visualized and bibliometric study to thoroughly construct the development trends and knowledge structure in the research field of stem cell therapy for meniscal regeneration in the past 10 years. The results thoroughly summarize and visualize the research frontiers, which will shed light on the research direction of stem cell therapy for meniscal regeneration.
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Affiliation(s)
- Zhen Yang
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China
| | - Zejun Fan
- Department of Biomedical Engineering, School of Medicine, Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing, China
| | - Du Wang
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China
| | - Hui Li
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China
| | - Zihao He
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China
| | - Dan Xing
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China,*Correspondence: Dan Xing, ; Jianhao Lin,
| | - Jianhao Lin
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing, China,Arthritis Institute, Peking University, Beijing, China,*Correspondence: Dan Xing, ; Jianhao Lin,
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Romaniyanto, Mahyudin F, Prakoeswa CRS, Notobroto HB, Tinduh D, Ausrin R, Rantam FA, Suroto H, Utomo DN, Rhatomy S. Hypoxia Effects in Intervertebral Disc-Derived Stem Cells and Discus Secretomes: An in vitro Study. Stem Cells Cloning 2022; 15:21-28. [PMID: 35655962 PMCID: PMC9153942 DOI: 10.2147/sccaa.s363951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/17/2022] [Indexed: 12/17/2022] Open
Abstract
Background This study aimed to investigate the effects of hypoxia and normoxia preconditioning in rabbit intervertebral disc-derived stem cells (IVDSCs) and discus-derived conditioned medium (DD-CM)/secretomes in vitro. Transforming growth factor (TGF)-β1, platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), and vascular endothelial growth factor (VEGF) have a role in the proliferation, development, differentiation, and migration of MSCs. Materials and Methods Intervertebral discs were isolated from rabbit and incubated in normoxia and hypoxia 1%, 3%, and 5% (hypoxia groups) condition. Cell counting was performed after 24 hours of manipulation, then analyzed using one-way ANOVA. TGF-β1, PDGF, FGF, and VEGF were measured using the ELISA. Results The highest number of cells was in the hypoxia 3% preconditioning compared to the normoxia, hypoxia 1%, and hypoxia 5% groups. Hypoxia 3% also had the highest increase in PDGF protein production compared to normoxia, with hypoxia 1% and 5%. Among hypoxia groups, the highest secretions of VEGF and FGF proteins were in the hypoxia 3% group. Based on TGF-β1 protein measurement, the hypoxia 1% group was the highest increase in this protein compared to other groups. Conclusion Oxygen level in hypoxia preconditioning has a role in the preparation of IVDSCs and secretome preparation in vitro. The highest cell numbers were found in the treatment group with 3% hypoxia, and 3% hypoxia was significantly related to support IVDSCs preparation. Preconditioning with 3% hypoxia had higher PDGF and VEGF levels than other hypoxia groups.
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Affiliation(s)
- Romaniyanto
- Doctoral Program, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.,Department of Orthopedic and Traumatology, Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia.,Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
| | - Ferdiansyah Mahyudin
- Department of Orthopedic and Traumatology, Dr. Soetomo General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Faculty of Medicine, Airlangga University, Surabaya, Indonesia.,Department of Dermatology and Venereology, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | | | - Damayanti Tinduh
- Faculty of Medicine, Airlangga University, Surabaya, Indonesia.,Department of Physical Medicine and Medical Rehabilitation, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ryan Ausrin
- Department of Orthopedic and Traumatology, Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia.,Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
| | - Fedik Abdul Rantam
- Virology and Immunology Laboratory, Microbiology Department, Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia.,Stem Cell Research and Development Center, Airlangga University, Surabaya, Indonesia
| | - Heri Suroto
- Department of Orthopedic and Traumatology, Dr. Soetomo General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Dwikora Novembri Utomo
- Department of Orthopedic and Traumatology, Dr. Soetomo General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Sholahuddin Rhatomy
- Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia.,Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Bian Y, Wang H, Zhao X, Weng X. Meniscus repair: up-to-date advances in stem cell-based therapy. Stem Cell Res Ther 2022; 13:207. [PMID: 35578310 PMCID: PMC9109379 DOI: 10.1186/s13287-022-02863-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/26/2022] [Indexed: 12/24/2022] Open
Abstract
The meniscus is a semilunar fibrocartilage between the tibia and femur that is essential for the structural and functional integrity of the keen joint. In addition to pain and knee joint dysfunction, meniscus injuries can also lead to degenerative changes of the knee joint such as osteoarthritis, which further affect patient productivity and quality of life. However, with intrinsic avascular property, the tearing meniscus tends to be nonunion and the augmentation of post-injury meniscus repair has long time been a challenge. Stem cell-based therapy with potent regenerative properties has recently attracted much attention in repairing meniscus injuries, among which mesenchymal stem cells were most explored for their easy availability, trilineage differentiation potential, and immunomodulatory properties. Here, we summarize the advances and achievements in stem cell-based therapy for meniscus repair in the last 5 years. We also highlight the obstacles before their successful clinical translation and propose some perspectives for stem cell-based therapy in meniscus repair.
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Affiliation(s)
- Yixin Bian
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Han Wang
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Xiuli Zhao
- Department of Medical Genetics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
| | - Xisheng Weng
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
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The Cell-Material Interaction in the Replacement and Regeneration of the Meniscus: A Mini-Review. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2022. [DOI: 10.4028/p-hfdp46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The meniscus is a part of the knee joint consisting of a medial and lateral component between the femoral condyles and the tibial plateau. Meniscal tears usually happen in younger and active people due to sports or daily activities. Some approaches are chosen for meniscus replacement and regeneration from the problems above, such as meniscal repair, meniscal allograft transplantation, gene therapy techniques, and tissue engineering techniques. Biomaterials and tissue engineering have a primary role in meniscus regeneration and replacement. The cell-material interactions are influenced by the biomaterials' design, structure, and composition to promote the growth o meniscus tissue. This study aims to give a brief review of the cell-material interaction in the replacement and regeneration process of the meniscus. Based on several studies, the use of growth factors in the meniscal regeneration and replacement could modulate and promote angiogenesis, differentiation, and cell migration beneficial in the repair process of the meniscus. Furthermore, combining the Mesenchymal Stem Cells and growth factors in healing the meniscal tears could be one of the best approaches to obtaining the new tissue resembling the meniscal tissue. The follow-up and long-term studies in meniscus regeneration and replacement are needed and recommended, especially implanting with good chondroprotective and long-term evaluation to obtain the best properties similar to the natural meniscus.
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Dai W, Wu T, Leng X, Yan W, Hu X, Ao Y. Advances in biomechanical and biochemical engineering methods to stimulate meniscus tissue. Am J Transl Res 2021; 13:8540-8560. [PMID: 34539978 PMCID: PMC8430175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
Meniscal injuries can cause cartilage degeneration, which usually leads to the development of osteoarthritis (OA) and results in progressive destruction of the knee joint. Therefore, it is important to identify methods to stop or slow the development of OA after the onset of meniscal defects. The current surgical techniques for meniscal injuries are insufficient to prevent the progression of knee OA, which has accelerated the development of alternative tissue engineering strategies. Much progress has been made in the use of biomechanical and biochemical stimuli in the past decades to engineer neotissue akin to native meniscus. In this review, we focus on the current progress in biomechanical and biochemical stimuli-based strategies applied to meniscal tissue engineering, and explore how these factors influence meniscal regeneration. By understanding the functional mechanism that can stimulate regeneration in the meniscus, we hope that this review will provide a theoretical basis and strategies for meniscus tissue engineering.
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Affiliation(s)
- Wenli Dai
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital49 North Garden Road, Haidian District, Beijing 100191, China
| | - Tong Wu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital49 North Garden Road, Haidian District, Beijing 100191, China
| | - Xi Leng
- Medical Imaging Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine16 Jichang Road, Baiyun District, Guangzhou 510405, Guangdong, China
| | - Wenqiang Yan
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital49 North Garden Road, Haidian District, Beijing 100191, China
| | - Xiaoqing Hu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital49 North Garden Road, Haidian District, Beijing 100191, China
| | - Yingfang Ao
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital49 North Garden Road, Haidian District, Beijing 100191, China
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Yang CP, Hung KT, Weng CJ, Chen ACY, Hsu KY, Chan YS. Clinical Outcomes of Meniscus Repair with or without Multiple Intra-Articular Injections of Platelet Rich Plasma after Surgery. J Clin Med 2021; 10:jcm10122546. [PMID: 34207554 PMCID: PMC8228048 DOI: 10.3390/jcm10122546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022] Open
Abstract
Preservation of the meniscal volume is crucial in meniscus repair. The goal of this study was to evaluate the clinical outcome of repeated intra-articular platelet-rich plasma (PRP) injections after arthroscopic repair of a traumatic meniscal tear. We retrospectively reviewed 61 primary meniscal repairs in 61 patients (PRP group: 30; non-PRP: 31) from 2017 to 2018. Patients in the PRP group received repeated intra-articular PRP injections in week 2,4,6 after the primary meniscus repair. Subsequent meniscal repair treatment or meniscectomy, knee arthroplasty, and IKDC changes of less than 11.5 points were defined as healing failures. After following up for at least 24 months, the IKDC score was 75.1 ± 13.6, and the Lysholm score was 80.6 ± 14.9 in the PRP group and 72.6 ± 15.8 (IKDC) and 77.7 ± 17.2 (Lysholm) in the non-PRP group. Healing rates of the PRP and the non-PRP groups were 93.3% (Kaplan-Meier 91.6%) and 87.1% (Kaplan-Meier 84.7%), respectively (log rank test p = 0.874). Our study is the first to use multiple intra-articular PRP injections to facilitate meniscal healing after meniscal repair. Though selection bias may be present in this study, the PRP group had similar functional outcome and healing rate compared to non-PRP group.
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Affiliation(s)
- Cheng-Pang Yang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kung-Tseng Hung
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Chun-Jui Weng
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Alvin Chao-Yu Chen
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kuo-Yao Hsu
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 2163)
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DePhillipo NN, LaPrade RF, Zaffagnini S, Mouton C, Seil R, Beaufils P. The future of meniscus science: international expert consensus. J Exp Orthop 2021; 8:24. [PMID: 33791890 PMCID: PMC8012449 DOI: 10.1186/s40634-021-00345-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/15/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the main focus areas for research and development for furthering the state of meniscus science in 2021. Methods An electronic survey including 10 questions was sent in a blind fashion to the faculty members of the 5th International Conference on Meniscus Science and Surgery. These faculty served as an expert consensus on the future of research and development areas of meniscus science. Survey responses were analyzed using descriptive statistics and ranking weighted averages were calculated to score survey questions. Results Of the 82 faculty, 76 (93%) from 18 different countries completed the survey (84% male, 16% female). The highest ranked future research and development focus areas were meniscus repair, biologics, osteotomy procedures, addressing meniscus extrusion, and the development of new therapies for the prevention of posttraumatic osteoarthritis. Currently, the most ‘valuable’ type of biologic reported for meniscus treatment was platelet-rich plasma. The main reported global research limitation was a lack of long-term clinical outcomes data. The most promising emerging medical technologies for improving meniscus science were 3-D printing, personalized medicine, and artificial implants. Conclusions This survey suggests that the future of meniscus science should be focused on meniscal preservation techniques through meniscus repair, addressing meniscal extrusion, and the use of orthobiologics. The lack of long-term clinical outcomes was the main reported research limitation globally for meniscus treatment. Future product development utilizing emerging medical technologies suggest the use of 3-D printing for meniscal transplants/scaffolds, personalized treatment, and bioengineering for artificial implants. Level of Evidence Level V. Supplementary Information The online version contains supplementary material available at 10.1186/s40634-021-00345-y.
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Affiliation(s)
| | | | | | - Caroline Mouton
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg, Clinique d'Eich, Luxembourg city, Luxembourg.,Sports Medicine and Science, Luxembourg Institute of Research in Orthopaedics, Luxembourg city, Luxembourg
| | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg, Clinique d'Eich, Luxembourg city, Luxembourg.,Sports Medicine and Science, Luxembourg Institute of Research in Orthopaedics, Luxembourg city, Luxembourg.,Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg city, Luxembourg
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10
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Zhu S, Tong G, Xiang J, Qiu S, Yao Z, Zhou X, Lin L. Microstructure Analysis and Reconstruction of a Meniscus. Orthop Surg 2021; 13:306-313. [PMID: 33403835 PMCID: PMC7862168 DOI: 10.1111/os.12899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/01/2020] [Accepted: 11/22/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To analyze the characteristics of menicus microstructure and to reconstruct a microstructure-mimicing 3D model of the menicus. METHODS Human and sheep meniscus were collected and prepared for this study. Hematoxylin-eosin staining (HE) and Masson staining were conducted for histological analysis of the meniscus. For submicroscopic structure analysis, the meniscus was first freeze-dried and then scanned by scanning electron microscopy (SEM). The porosity of the meniscus was determined according to SEM images. A micro-MRI was used to scan each meniscus, immersed in distilled water, and a 3D digital model was reconstructed afterwards. A three-dimensional (3D) resin model was printed out based on the digital model. Before high-resolution micro-CT scanning, each meniscus was freeze-dried. Then, micro-scale two-dimensional (2D) CT projection images were obtained. The porosity of the meniscus was calculated according to micro-CT images. With micro-CT, multiple 2D projection images were collected. A 3D digital model based on 2D CT pictures was also reconstructed. The 3D digital model was exported as STL format. A 3D resin model was printed by 3D printer based on the 3D digital model. RESULTS As revealed in the HE and Masson images, a meniscus is mostly composed of collagen, with a few cells disseminated between the collagen fiber bundles at the micro-scale. The SEM image clearly shows the path of highly cross-linked collagen fibers, and massive pores exist between the fibers. According to the SEM images, the porosity of the meniscus was 34.1% (34.1% ± 0.032%) and the diameters of the collagen fibers were varied. In addition, the cross-linking pattern of the fibers was irregular. The scanning accuracy of micro-MRI was 50 μm. The micro-MRI demonstrated the outline of the meniscus, but the microstructure was obscure. The micro-CT clearly displayed microfibers in the meniscus with a voxel size of 11.4 μm. The surface layer, lamellar layer, circumferential fibers, and radial fibers could be identified. The mean porosity of the meniscus according to micro-CT images was 33.92% (33.92% ± 0.03%). Moreover, a 3D model of the microstructure based on the micro-CT images was built. The microscale fibers could be displayed in the micro-CT image and the reconstructed 3D digital model. In addition, a 3D resin model was printed out based on the 3D digital model. CONCLUSION It is extremely difficult to artificially simulate the microstructure of the meniscus because of the irregularity of the diameter and cross-linking pattern of fibers. The micro-MRI images failed to demonstrate the meniscus microstructure. Freeze-drying and micro-CT scanning are effective methods for 3D microstructure reconstruction of the meniscus, which is an important step towards mechanically functional 3D-printed meniscus grafts.
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Affiliation(s)
- Shuang Zhu
- Department of Joint and OrthopaedicsZhujiang Hospital, Southern Medical UniversityGuangzhouChina
| | - Ge Tong
- Department of Medical Ultrasonics, Guangdong Province Key Laboratory of Hepatology ResearchThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jian‐ping Xiang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgerythe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Shuai Qiu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgerythe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Zhi Yao
- Musculoskeletal Research Laboratory, Department of Orthopaedics and TraumatologyThe Chinese University of Hong KongHong KongChina
| | - Xiang Zhou
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgerythe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Li‐jun Lin
- Department of Joint and OrthopaedicsZhujiang Hospital, Southern Medical UniversityGuangzhouChina
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11
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Donahue RP, Gonzalez-Leon EA, Hu JC, Athanasiou KA. Considerations for translation of tissue engineered fibrocartilage from bench to bedside. J Biomech Eng 2018; 141:2718210. [PMID: 30516244 PMCID: PMC6611470 DOI: 10.1115/1.4042201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/27/2018] [Indexed: 12/25/2022]
Abstract
Fibrocartilage is found in the knee meniscus, the temporomandibular joint (TMJ) disc, the pubic symphysis, the annulus fibrosus of intervertebral disc, tendons, and ligaments. These tissues are notoriously difficult to repair due to their avascularity, and limited clinical repair and replacement options exist. Tissue engineering has been proposed as a route to repair and replace fibrocartilages. Using the knee meniscus and TMJ disc as examples, this review describes how fibrocartilages can be engineered toward translation to clinical use. Presented are fibrocartilage anatomy, function, epidemiology, pathology, and current clinical treatments because they inform design criteria for tissue engineered fibrocartilages. Methods for how native tissues are characterized histomorphologically, biochemically, and mechanically to set gold standards are described. Then, provided is a review of fibrocartilage-specific tissue engineering strategies, including the selection of cell sources, scaffold or scaffold-free methods, and biochemical and mechanical stimuli. In closing, the Food and Drug Administration paradigm is discussed to inform researchers of both the guidance that exists and the questions that remain to be answered with regard to bringing a tissue engineered fibrocartilage product to the clinic.
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Affiliation(s)
- Ryan P. Donahue
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Erik A. Gonzalez-Leon
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Jerry C. Hu
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Kyriacos A. Athanasiou
- Fellow ASME
Department of Biomedical Engineering,
University of California, Irvine
Irvine, CA 92697
e-mail:
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