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Review
. 2021 Dec;13(8):2185-2195.
doi: 10.1111/os.13002. Epub 2021 Nov 8.

In Vivo Studies of Mesenchymal Stem Cells in the Treatment of Meniscus Injury

Tian-Yu Dai #  1 , Zhang-Yi Pan #  1 , Feng Yin  1
Affiliations
Review

In Vivo Studies of Mesenchymal Stem Cells in the Treatment of Meniscus Injury

Tian-Yu Dai et al. Orthop Surg. 2021 Dec.

Abstract

This review summarizes the literature of preclinical studies and clinical trials on the use of mesenchymal stem cells (MSCs) to treat meniscus injury and promote its repair and regeneration and provide guidance for future clinical research. Due to the special anatomical features of the meniscus, conservative or surgical treatment can hardly achieve complete physiological and histological repair. As a new method, stem cells promote meniscus regeneration in preclinical research and human preliminary research. We expect that, in the near future, in vivo injection of stem cells to promote meniscus repair can be used as a new treatment model in clinical treatment. The treatment of animal meniscus injury, and the clinical trial of human meniscus injury has begun preliminary exploration. As for the animal experiments, most models of meniscus injury are too simple, which can hardly simulate the complexity of actual meniscal tears, and since the follow-up often lasts for only 4-12 weeks, long-term results could not be observed. Lastly, animal models failed to simulate the actual stress environment faced by the meniscus, so it needs to be further studied if regenerated meniscus has similar anti-stress or anti-twist features. Despite these limitations, repair of the meniscus by MSCs has great potential in clinics. MSCs can differentiate into fibrous chondrocytes, which can possibly repair the meniscus and provide a new strategy for repairing meniscus injury.

Keywords: Cytology treatment; MSCs; Meniscus injury.

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Figures

Fig 1
Fig 1
Illustration of meniscus demonstrating the classic three zones according to the reported vascularity. R‐R, red‐red; R‐W, red‐white; W‐W, white‐white. The R‐R zone has a good blood supply, if the tear is very small, sometimes it can heal on its own and may not necessarily require surgical treatment. The R‐W zone has partial blood supply and its self‐healing potential is low. There is almost no blood supply in the W‐W zone, and a tear in this area will not heal by itself.
Fig 2
Fig 2
Anatomical structure of meniscus and type of injury. The types of meniscus injury include vertical (A), radial (B), horizontal (C), bucket handle‐like tears (D), and oblique (E). Annular capillaries formed by the upper and lower arteries can provide limited blood flow for the tissue in 10%–25% of the lateral meniscus rim, 10%–30% of the medial meniscus rim, and in the anterior and posterior horns of the meniscus (Red Zone, F). The tears in the white zone have limited ability to self‐repair; patients may suffer persistent and repeated symptoms, as well as aggravated injuries, due to the lack of self‐healing.
Fig 3
Fig 3
Retrieval process for literature for this article includes five inclusion criteria and three exclusion criteria. A literature search from 1997 to 2017 was conducted and all studies evaluating development and application were included in the review. There were 694 records identified through database searching; 398 records were excluded and only 34 articles were included in the qualitative synthesis. In all, 32 articles were animal research, and the others were human research.
Fig 4
Fig 4
Cytological treatment of meniscus injury using MSCs. As the structural characteristics of the joint capsule, the knee joint is a relatively closed space. The prepared stem cell preparations can be injected directly into the joint cavity through the skin.
See this image and copyright information in PMC

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