Preclinical Use of FGF-18 Augmentation for Improving Cartilage Healing Following Surgical Repair: A Systematic Review.
Abstract: To evaluate the efficacy of fibroblast growth factor-18 (FGF-18) augmentation for improving articular cartilage healing following surgical repair in preclinical () animal models. A systematic review was performed evaluating the efficacy of FGF-18 augmentation with cartilage surgery compared with cartilage surgery without FGF-18 augmentation in living animal models. Eligible intervention groups were FGF-18 treatment in conjunction with orthopedic procedures, including microfracture, osteochondral auto/allograft transplantation, and cellular-based repair. Outcome variables were: International Cartilage Repair Society (ICRS) score, modified O'Driscoll histology score, tissue infill score, qualitative histology, and adverse events. Descriptive statistics were recorded and summarized for each included study. In total, 493 studies were identified and 4 studies were included in the final analysis. All studies were randomized controlled trials evaluating use of recombinant human FGF-18 (rhFGF-18). Animal models included ovine ( = 3) and equine ( = 1), with rhFGF-18 use following microfracture ( = 3) or osteochondral defect repair ( = 1). The rhFGF-18 was delivered via intra-articular injection ( = 2), collagen membrane scaffold ( = 1), or both ( = 1). All studies reported significant, positive improvements in cartilage defect repair with rhFGF-18 compared with controls based on ICRS score ( = 4), modified O'Driscoll score ( = 4), tissue infill ( = 3), and expression of collagen type II ( = 4) ( < 0.05). No adverse events were reported with the intra-articular administration of this growth factor, indicating short-term safety and efficacy of rhFGF-18 . This systematic review provides evidence that rhFGF-18 significantly improves cartilage healing at 6 months postoperatively following microfracture or osteochondral defect repair in preclinical randomized controlled trials.
Publication Date: 2022-12-21 PubMed ID: 36541606PubMed Central: PMC10076894DOI: 10.1177/19476035221142010Google Scholar: Lookup
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- Systematic Review
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research article discusses the effectiveness of a protein called fibroblast growth factor-18 (FGF-18) in enhancing the healing process of articular cartilage after surgical repair, specifically in animal models. The results show that FGF-18 substantially improves the repair of cartilage defects when administered postoperatively.
Research Methodology
- The research conducted a systematic review to evaluate the efficacy of FGF-18 augmentation with cartilage surgery in comparison with cartilage surgery without FGF-18 augmentation. The test subjects used in the study were living animal models.
- The interventions applicable for review were instances in which FGF-18 treatment was applied in conjunction with orthopedic procedures. These procedures include microfracture, osteochondral auto/allograft transplantation, and cellular-based repair.
- The outcomes of the interventions were assessed using several variables. These include International Cartilage Repair Society (ICRS) score, modified O’Driscoll histology score, tissue infill score, qualitative histology, and any adverse events.
Data Collection and Analysis
- From a total of 493 studies, only 4 were included in the final analysis. The criteria for inclusion required the studies to be randomized controlled trials specifically evaluating the use of recombinant human FGF-18 (rhFGF-18).
- The animal models used in the studies were sheep (ovine) and horse (equine). The experiments utilizing rhFGF-18 were conducted following microfracture in 3 instances, or osteochondral defect repair in 1 instance.
- The administration of rhFGF-18 was executed via intra-articular injection, collagen membrane scaffold, or a combination of both, depending on the individual study.
Results
- All the studies that were reviewed reported significant positive improvements in the repair of cartilage defects with the use of rhFGF-18 compared to controls. This was based on several scoring systems including ICRS score, modified O’Driscoll score, tissue infill, and expression of collagen type II.
- Importantly, the application of rhFGF-18 did not cause any adverse events, demonstrating its short-term safety and efficacy.
Conclusion
- This study concludes that rhFGF-18 significantly improves the healing of cartilage at 6 months postoperatively following microfracture or osteochondral defect repair based on evidence gathered from preclinical randomized controlled trials.
Cite This Article
APA
DePhillipo NN, Hendesi H, Aman ZS, Lind DRG, Smith J, Dodge GR.
(2022).
Preclinical Use of FGF-18 Augmentation for Improving Cartilage Healing Following Surgical Repair: A Systematic Review.
Cartilage, 14(1), 59-66.
https://doi.org/10.1177/19476035221142010 Publication
Researcher Affiliations
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
- Mechano-Therapeutics LLC, Philadelphia, PA, USA.
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
- Mechano-Therapeutics LLC, Philadelphia, PA, USA.
MeSH Terms
- Animals
- Humans
- Sheep
- Horses
- Fractures, Stress
- Cartilage, Articular / surgery
- Cartilage, Articular / pathology
- Fibroblast Growth Factors / pharmacology
- Fibroblast Growth Factors / therapeutic use
- Collagen
Conflict of Interest Statement
The author(s) declared no potential conflicts of interest with respect to the
research, authorship, and/or publication of this article.
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Citations
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