Is cellular therapy beneficial in management of rotator cuff tears?Meta-analysis of comparative clinical studies

作     者：Sathish Muthu Cheruku Mogulesh Vibhu Krishnan Viswanathan Naveen Jeyaraman Satvik N Pai Madhan Jeyaraman Manish Khanna 

作者机构：Department of OrthopaedicsGovernment Medical College and HospitalDindigul 624001Tamil NaduIndia Department of BiotechnologySchool of Engineering and TechnologySharda UniversityGreater Noida 201306Uttar PradeshIndia Indian Stem Cell Study Group AssociationLucknow 226010Uttar PradeshIndia Department of Orthopaedic RheuamtologyDr Ram Manohar Lohiya National Law UniversityLucknow 226010Uttar PradeshIndia Department of MSK OncologyUniversity of CalgaryAlberta AB T2N 1N4AlbertaCanada Department of OrthopaedicsAtlas Hospitals(The Tamil Nadu Dr MGR Medical University)Tiruchirappalli 620002Tamil NaduIndia Department of OrthopaedicsSri Ramachandra Medical College and Research InstituteChennai 600116Tamil NaduIndia Department of OrthopaedicsFaculty of MedicineSri Lalithambigai Medical College and HospitalDr MGR Educational and Research InstituteChennai 600095Tamil NaduIndia Department of OrthopaedicsSouth Texas Orthopaedic Research Institute(STORI Inc.)LaredoTX 78045United States Department of OrthopaedicsAutonomous State Medical CollegeAyodhya 224135Uttar PradeshIndia 

出 版 物：《World Journal of Meta-Analysis》 (世界荟萃分析杂志)

年 卷 期：2022年第10卷第3期

页      面：162-176页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Mesenchymal stromal cell Bone-marrow derived mesenchymal stromal cell Adipose-derived mesenchymal stromal cell Rotator cuff tear Cellular therapy Meta-analysis 

摘      要：BACKGROUND Mesenchymal stromal cell(MSC)-based cellular therapy promotes type I collagen production,enhance mechanical strength of tissues,and enhance biology at the bone-tendon interface,which primarily explains their potential clinical utility in rotator cuff(RC)*** To analyze the efficacy and safety of cellular therapy utilizing MSCs in the management of RC tears from clinical studies available in the *** We conducted independent and duplicate electronic database searches including PubMed,Embase,Reference Citation Anallysis,Web of Science,and Cochrane Library in August 2021 for studies analyzing the efficacy and safety of cellular therapy(CT)utilizing MSCs in the management of RC *** Analog Score(VAS)score for pain,American Shoulder and Elbow Surgeons(ASES)score,Disability of the Arm,Shoulder,and Hand score,Constant score,radiological assessment of healing,and complications such as retear rate and adverse events were the outcomes *** was performed in R-platform using OpenMeta[Analyst]*** Six studies involving 238 patients were included for *** noted a significant reduction in VAS score for pain at 3 mo(weighed mean difference[WMD]=-2.234,P0.001)and 6 mo(WMD=-3.078,P0.001)with the use of CT,which was not maintained at long-term follow-up(WMD=-0.749,P=0.544).Concerning functional outcomes,utilization of CT produced a significant shortterm improvement in the ASES score(WMD=17.090,P0.001)and significant benefit in functional scores such as Constant score(WMD=0.833,P=0.760)at long-term ***,we also observed significantly improved radiological tendon healing during the longterm follow-up(odds ratio[OR]=3.252,P=0.059).We also noted a significant reduction in the retear rate upon utilization of CT in RC tears both at short-(OR=0.079,P=0.032)and long-term(OR=0.434,P=0.027)*** did not observe any significant increase in the adverse events directly related to cellular therapy,as comp