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Large Animal Models of Meniscus Repair and Regeneration: A Systematic Review of the State of the Field

机译:半月板修复和再生的大型动物模型:领域状态的系统评价

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摘要

Injury to the meniscus is common, but few viable strategies exist for its repair or regeneration. To address this, animal models have been developed to translate new treatment strategies toward the clinic. However, there is not yet a regulatory document guiding such studies. The purpose of this study was to carry out a systematic review of the literature on meniscus treatment methods and outcomes to define the state of the field. Public databases were queried by using search terms related to animal models and meniscus injury and/or repair over the years 1980–2015. Identified peer-reviewed manuscripts were screened by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. One of nine reviewers read each manuscript and scored them based on whether the publication described a series of predefined study descriptors and outcome measures. Additional data were extracted to identify common assays used. A total of 128 full-length peer-reviewed manuscripts were identified. The number of publications increased over the time frame analyzed, with 48% focused on augmented repair. Rabbit was, by far, the most prevalent species utilized (46%), with dog (21%) and sheep (20%) being the next most common. Analysis of study descriptors revealed that most studies appropriately documented details of the animal used, the surgical approach, and defect and implant characteristics (e.g., 63% of studies identified clearly the defect size). In terms of outcome parameters, most studies carried out macroscopic (85%), histologic (90%), and healing/integration (83%) analyses of the meniscus. However, many studies did not provide further analysis beyond these fundamental measures, and less than 40% reported on the adjacent cartilage and synovium, as well as joint function. There is intense interest in the field of meniscus repair. However, given the current lack of guidance documentation in this area, preclinical animal models are not performed in a standardized fashion. The development of a “Best Practices” document would increase reproducibility and external validity of experiments, while accelerating advancements in translational research. Advancement is of paramount importance given the high prevalence of meniscal injuries and the paucity of effective repair or regenerative strategies.
机译:半月板损伤是常见的,但是几乎没有可行的修复或再生策略。为了解决这个问题,已经开发了动物模型以将新的治疗策略应用于临床。但是,尚无指导此类研究的法规文件。这项研究的目的是对半月板治疗方法和结果的文献进行系统的综述,以定义该领域的状况。通过使用与1980-2015年间动物模型和半月板损伤和/或修复有关的搜索词来查询公共数据库。通过使用系统评价和元分析的首选报告项目(PRISMA)指南,筛选出经过同行评审的已鉴定手稿。九位审稿人之一阅读了每份手稿,并根据出版物是否描述了一系列预定义的研究描述符和结果指标对它们进行评分。提取其他数据以鉴定所用的常用测定。共鉴定了128篇经同行评审的全长手稿。在分析的时间范围内,出版物的数量有所增加,其中48%的重点是增强维修。到目前为止,兔子是最普遍使用的物种(46%),其次是犬(21%)和绵羊(20%)。对研究描述符的分析表明,大多数研究适当地记录了所用动物,手术方法以及缺陷和植入物特征的详细信息(例如,有63%的研究清楚地确定了缺陷大小)。在结果参数方面,大多数研究对弯液面进行了宏观(85%),组织学(90%)和愈合/整合(83%)分析。但是,除了这些基本措施外,许多研究没有提供进一步的分析,并且少于40%的患者报告了邻近的软骨和滑膜以及关节功能。在半月板修复领域中存在强烈的兴趣。但是,由于目前在该领域缺乏指导性文件,临床前动物模型不能以标准化方式进行。开发“最佳实践”文档将提高实验的可重复性和外部有效性,同时加快翻译研究的进展。鉴于半月板损伤的患病率很高且缺乏有效的修复或再生策略,因此进步至关重要。

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