Year: 2025 | Month: April | Volume: 12 | Issue: 4 | Pages: 7-15
DOI: https://doi.org/10.52403/ijrr.20250402
Intralesional Secretome Injection in Anterior Cruciate Ligament Reconstruction: A Systematic Review
I Gusti Ngurah Yuda Bagus Aryana1, I Gusti Ngurah Wien Aryana2, Febyan3, Erfan Sanjaya3
1Faculty of Medicine, Udayana University, Bali, Indonesia
2Sport Consultant, Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Prof Ngoerah General Hospital, Bali, Indonesia
3Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Prof Ngoerah General Hospital, Bali, Indonesia
Corresponding Author: I Gusti Ngurah Yuda Bagus Aryana
ABSTRACT
Background and Objectives: Traditional ACL reconstruction (ACLR) faces challenges like graft failure, donor site morbidity, and prolonged recovery. Secretome-based therapies, composed of bioactive molecules from stem cells, offer a promising regenerative approach by promoting tissue repair, reducing inflammation, and enhancing graft integration. This systematic review aims to evaluate the efficacy of intralesional secretome injection in ACL graft augmentation compared to traditional ACL reconstruction.
Methods: A systematic review was conducted following PRISMA guidelines. A comprehensive search was performed in PubMed, Scopus, Cochrane Library, Web of Science, and Embase for studies published up to February 10, 2025. Eligible studies included animal studies, randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effects of intralesional secretome injection on ACL graft augmentation.
Results: Five preclinical studies were included, all conducted in animal models. The findings indicated that secretome-treated groups exhibited faster bone tunnel closure, higher BV/TV, increased mechanical strength, and enhanced collagen deposition compared to control groups. Histological analysis demonstrated reduced tendon-bone interface width, formation of Sharpey-like fibers, and increased chondrocytes and fibrocartilage, suggesting enhanced tendon-bone integration. Additionally, a study on horses reported a lower reinjury rate (15.38%) in the secretome-treated group compared to untreated controls, with no adverse effects, abnormal tissue growth, or tumor development reported in any of the studies.
Conclusion: Secretome therapy shows promising potential in enhancing ACL graft healing and improving bone regeneration, mechanical properties, and histological integration. The absence of reported adverse effects further supports its safety profile. However, due to the lack of clinical trials, further research is needed to determine the real-world efficacy and long-term outcomes of secretome-based interventions in ACL reconstruction. Future studies should focus on well-designed human clinical trials, standardized secretome application protocols, and functional outcome assessments to validate their role in clinical practice.
Keywords: Bisphosphonates; ONJ; Pamidronate; Zoledronic acid
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