Abstract
Background: Multiple studies have focused on stem cell-based treatments for rotator cuff disorders; however, the outcomes are not consistent.
Objectives: This systematic review and meta-analysis were performed to evaluate the effects of stem cells on rotator cuff healing.
Methods: A detailed search of relevant studies was conducted in three databases including Pubmed/ Medline, Cochrane library, and Embase databases, using the following keywords: “rotator cuff” or “Tissue Engineering” AND “stem cell” from inception to January 01, 2019. The standard mean difference (SMD) and 95% confidence interval (CI) for each individual study were extracted from the original studies or calculated based on relevant data and pooled to obtain integrated estimates using random effects modeling.
Results: A total of 22 studies were identified. The results demonstrated that the ultimate strain in the stem cell group was significantly higher than that in the control group at 4 and 8 weeks. Muscle weight in the stem cell group was higher than the control group at 8 weeks, while no significant differences were detected at 16 weeks. The stem cell group had lower visual analog scale scores (VAS) at 1, 3, and 6 months, and higher American shoulder and elbow surgeons score (ASES) at 3 months. In addition, the walking distance, time, and speed in the stem cell group were significantly superior to those in the control group.
Conclusions: This meta-analysis confirms that stem cells improved the rehabilitation of rotator cuff disorders. However, larger-scale studies are needed to further support these findings.
Keywords: Rotator cuff, rotator cuff disorders, stem cell, tissue engineering, regenerative therapy, meta-analysis.
Erratum In:
Stem Cells in Rotator Cuff Injuries and Reconstructions: A Systematic
Review and Meta-Analysis
[http://dx.doi.org/10.1136/ard.57.11.649] [PMID: 9924205]
[http://dx.doi.org/10.1016/j.jse.2009.04.006] [PMID: 19540777]
[http://dx.doi.org/10.1007/s11999-009-0781-2] [PMID: 19283436]
[http://dx.doi.org/10.1007/s00167-014-3234-8] [PMID: 25145945]
[PMID: 8917870]
[http://dx.doi.org/10.5435/00124635-201106000-00007] [PMID: 21628648]
[http://dx.doi.org/10.1016/j.jse.2006.12.011] [PMID: 17629505]
[http://dx.doi.org/10.1002/jor.20441] [PMID: 17600822]
[http://dx.doi.org/10.2106/00004623-199312000-00009] [PMID: 8258550]
[http://dx.doi.org/10.1115/1.1536660] [PMID: 12661203]
[http://dx.doi.org/10.1016/j.jbiomech.2005.05.021] [PMID: 16024026]
[http://dx.doi.org/10.1634/stemcells.2007-0637] [PMID: 17901396]
[http://dx.doi.org/10.1371/journal.pone.0012248] [PMID: 20805884]
[http://dx.doi.org/10.1007/s00167-011-1607-9] [PMID: 21773831]
[http://dx.doi.org/10.1177/0363546516657827] [PMID: 27501832]
[http://dx.doi.org/10.1016/j.addr.2014.11.015] [PMID: 25446135]
[http://dx.doi.org/10.1016/j.transproceed.2006.03.023] [PMID: 16797364]
[PMID: 26509369]
[http://dx.doi.org/10.1080/03008207.2016.1189909] [PMID: 27191749]
[http://dx.doi.org/10.1186/s40634-017-0117-1] [PMID: 29330711]
[http://dx.doi.org/10.3727/096368917X694705] [PMID: 28105983]
[PMID: 29253149]
[http://dx.doi.org/10.1007/s10561-019-09750-1] [PMID: 30673902]
[http://dx.doi.org/10.1177/0363546512442343] [PMID: 22491821]
[http://dx.doi.org/10.1371/journal.pone.0174789] [PMID: 28369135]
[http://dx.doi.org/10.1159/000438632] [PMID: 26824451]
[http://dx.doi.org/10.1177/0363546509339582] [PMID: 19684297]
[PMID: 19723669]
[http://dx.doi.org/10.1089/ten.tea.2015.0101] [PMID: 26414599]
[http://dx.doi.org/10.5966/sctm.2015-0040] [PMID: 26371340]
[http://dx.doi.org/10.1016/j.arthro.2016.04.019] [PMID: 27282111]
[http://dx.doi.org/10.1007/s12015-018-9829-6] [PMID: 29855989]
[http://dx.doi.org/10.1155/2018/7146384] [PMID: 29861743]
[http://dx.doi.org/10.1016/j.jse.2018.08.044] [PMID: 30527883]
[http://dx.doi.org/10.1002/jcb.27143] [PMID: 30105826]
[http://dx.doi.org/10.1016/S0020-1383(14)70006-3] [PMID: 25384471]
[http://dx.doi.org/10.1186/s13018-015-0269-6] [PMID: 26268217]
[http://dx.doi.org/10.3727/096368911X627453] [PMID: 22405331]
[http://dx.doi.org/10.1016/j.jse.2015.08.008] [PMID: 26387915]
[http://dx.doi.org/10.1016/j.biomaterials.2018.10.037] [PMID: 30453215]
[PMID: 24488915]
[http://dx.doi.org/10.3727/096368915X686968] [PMID: 25654771]
[http://dx.doi.org/10.1186/s13018-017-0693-x] [PMID: 29298726]
[http://dx.doi.org/10.1002/stem.2855] [PMID: 29790618]
[http://dx.doi.org/10.3961/jpmph.2013.46.1.39] [PMID: 23407585]
[http://dx.doi.org/10.2174/1574888X09666140710101001] [PMID: 25012743]
[http://dx.doi.org/10.1007/s10735-015-9615-6] [PMID: 25782868]
[http://dx.doi.org/10.2174/1574888X09666140710103154] [PMID: 25012739]
[http://dx.doi.org/10.1172/JCI22689] [PMID: 16585960]
[http://dx.doi.org/10.1159/000095985] [PMID: 17108682]
[http://dx.doi.org/10.1002/(SICI)1097-4644(1998)72:30/31+<284:AID-JCB34>3.0.CO;2-I] [PMID: 9893281]
[http://dx.doi.org/10.1016/S0014-4827(03)00107-1] [PMID: 12837285]
[PMID: 7773478]
[http://dx.doi.org/10.1007/s00167-014-2923-7] [PMID: 24623185]
[http://dx.doi.org/10.1016/j.jse.2013.07.054] [PMID: 24129058]
[http://dx.doi.org/10.1016/j.jse.2012.04.014] [PMID: 22818894]
[http://dx.doi.org/10.22203/eCM.v032a15] [PMID: 27763655]
[http://dx.doi.org/10.1002/bies.201670915] [PMID: 27417126]