Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review

Introduction. Tendinopathies are a common cause of disability among the general population, and their management is challenging due to the degenerative nature of these disorders. The aim of this paper is to perform a scoping review of the available clinical evidence on the application of cell-based...

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Main Authors: Berardo Di Matteo, Riccardo Ranieri, Angelo Manca, Simone Cappato, Maurilio Marcacci, Elizaveta Kon, Alessandro Castagna
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Stem Cells International
Online Access:http://dx.doi.org/10.1155/2021/5558040
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author Berardo Di Matteo
Riccardo Ranieri
Angelo Manca
Simone Cappato
Maurilio Marcacci
Elizaveta Kon
Alessandro Castagna
author_facet Berardo Di Matteo
Riccardo Ranieri
Angelo Manca
Simone Cappato
Maurilio Marcacci
Elizaveta Kon
Alessandro Castagna
author_sort Berardo Di Matteo
collection DOAJ
description Introduction. Tendinopathies are a common cause of disability among the general population, and their management is challenging due to the degenerative nature of these disorders. The aim of this paper is to perform a scoping review of the available clinical evidence on the application of cell-based therapies for the management of elbow and rotator cuff tendinopathies, in order to summarize the current application methods and to shed light on the therapeutic potential and current limitations of these biologic approaches. Materials and Methods. A scoping review of the literature was performed on the PubMed and Scopus databases using the following inclusion criteria: clinical reports of any level of evidence, written in English, with no time limitation, on the use of cell-based approaches to treat rotator cuff or elbow tendinopathies, including studies on biological augmentation during the surgical procedure. Exclusion criteria were as follows: case reports or mini case series (<5 patients), articles not written in English, and reviews. Relevant data were then extracted and collected in a single database with the consensus of the two observers to be analyzed for the purposes of the present manuscript. Results. Seven papers dealing with rotator cuff tears were included. Four of them investigated the effect of injections, either MSCs alone or in combination with PRP, whereas three studies investigated the use of MSCs in combination with surgery. In all cases, an improvement was found in terms of clinical scores, with even evidence of tendon healing documented at second-look arthroscopy. Six papers dealt with elbow tendinopathies: three studies described the use of MSCs either with or without surgery, reporting significant clinical improvement and three studies analyzed the use of different types of cells (collagen-producing cells and autologous tenocytes) and, even in this case, clinical improvement was reported. Conclusion. All the papers included suggested a beneficial role of cell-based approaches to treat common upper limb tendinopathies, with an overall satisfactory safety profile. However, the lack of high-level evidence and the presence of controversial issues, such as interproduct variability, harvest source, and application strategies, do not allow standardization of these novel biologic approaches, whose efficacy needs to be confirmed with properly designed randomized trials.
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spelling doaj-art-d64ba22fd0e54f82a0f43c458798dcad2025-02-03T06:43:49ZengWileyStem Cells International1687-966X1687-96782021-01-01202110.1155/2021/55580405558040Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping ReviewBerardo Di Matteo0Riccardo Ranieri1Angelo Manca2Simone Cappato3Maurilio Marcacci4Elizaveta Kon5Alessandro Castagna6Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyHumanitas San Pio X Institute, Milano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyIntroduction. Tendinopathies are a common cause of disability among the general population, and their management is challenging due to the degenerative nature of these disorders. The aim of this paper is to perform a scoping review of the available clinical evidence on the application of cell-based therapies for the management of elbow and rotator cuff tendinopathies, in order to summarize the current application methods and to shed light on the therapeutic potential and current limitations of these biologic approaches. Materials and Methods. A scoping review of the literature was performed on the PubMed and Scopus databases using the following inclusion criteria: clinical reports of any level of evidence, written in English, with no time limitation, on the use of cell-based approaches to treat rotator cuff or elbow tendinopathies, including studies on biological augmentation during the surgical procedure. Exclusion criteria were as follows: case reports or mini case series (<5 patients), articles not written in English, and reviews. Relevant data were then extracted and collected in a single database with the consensus of the two observers to be analyzed for the purposes of the present manuscript. Results. Seven papers dealing with rotator cuff tears were included. Four of them investigated the effect of injections, either MSCs alone or in combination with PRP, whereas three studies investigated the use of MSCs in combination with surgery. In all cases, an improvement was found in terms of clinical scores, with even evidence of tendon healing documented at second-look arthroscopy. Six papers dealt with elbow tendinopathies: three studies described the use of MSCs either with or without surgery, reporting significant clinical improvement and three studies analyzed the use of different types of cells (collagen-producing cells and autologous tenocytes) and, even in this case, clinical improvement was reported. Conclusion. All the papers included suggested a beneficial role of cell-based approaches to treat common upper limb tendinopathies, with an overall satisfactory safety profile. However, the lack of high-level evidence and the presence of controversial issues, such as interproduct variability, harvest source, and application strategies, do not allow standardization of these novel biologic approaches, whose efficacy needs to be confirmed with properly designed randomized trials.http://dx.doi.org/10.1155/2021/5558040
spellingShingle Berardo Di Matteo
Riccardo Ranieri
Angelo Manca
Simone Cappato
Maurilio Marcacci
Elizaveta Kon
Alessandro Castagna
Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
Stem Cells International
title Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
title_full Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
title_fullStr Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
title_full_unstemmed Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
title_short Cell-Based Therapies for the Treatment of Shoulder and Elbow Tendinopathies: A Scoping Review
title_sort cell based therapies for the treatment of shoulder and elbow tendinopathies a scoping review
url http://dx.doi.org/10.1155/2021/5558040
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