Mesenchymal stem cells and their application to rotator cuff pathology: A meta-analysis of pre-clinical studies

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Rotator cuff injury (RCI) is a leading cause of morbidity in orthopaedics. Advances in regenerative medicine have led to the novel pleiotropic effects of mesenchymal stromal cells (MSCs) as therapeutic agents for RCI. Objective Conduct a systematic evaluation of available preclinical studies to quantify the effects of MSCs on RCI. Methods A literature search was performed in PubMed, Scopus, Cochrane, CINAHL, and Google Scholar. At least two independent investigators screened animal studies assessing the therapeutic effects of MSCs on: (i) biomechanical testing, imaging, and/or range-of-motion (primary outcome), and (ii) histologic analyses of wound healing, gene/protein expression of regenerative factors, and safety/long-term outcomes (secondary outcome). Meta-analysis data is reported as standardized mean difference (SMD) with 95% confidence interval (CI). Results A total of 858 titles and abstracts were screened; 18 studies (n=576) met inclusion criteria. MSC therapy improved ultimate load failure [SMD -0.43 (95% CI -0.65, -0.22), p Conclusion Administration of MSCs in preclinical models recapitulating RCI improved aspects of shoulder biomechanics, imaging, and collagen formation. Although these findings are promising, future studies should attempt to limit the risk of bias and focus on optimizing MSCs by standardizing methodologies.

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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