Intralesional Secretome Injection in Anterior Cruciate Ligament Reconstruction: A Systematic Review
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…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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