Autologous perichondral tissue for meniscal replacement

Abstract

Our aim was to examine the potential of autologous perichondral tissue to form a meniscal replacement. In 18 mature sheep we performed a complete medial meniscectomy. The animals were then divided into two groups: 12 had a meniscal replacement using strips of autologous perichondral tissue explanted from the lower rib (group G) and six (group C) served as a control group without a meniscal replacement. In all animals restriction from weight-bearing was achieved by means of transection and partial resection of tendo Achillis. Six animals (four from group G and two from group C) were each killed at 3, 6 and 12 months. The grafts and the underlying articular cartilage were removed and studied by gross macroscopic examination, light microscopy, SEM, polarised light examination, and by biomechanical tests.In all the transplanted animals a new perichondral meniscus developed. After three months the transplants resembled normal menisci in size and thickness, while in the control animals only small rims of spontaneously grown tissue were seen. Microscopically, the perichondral menisci showed a normal orientation of collagen fibres and normal cellular characteristics, but in the central region, areas of calcification disturbed the regular tissue differentiation. Healing tissue in control animals lacked the normal fibre orientation and cellularity. SEM of perichondral menisci showed surface characteristics similar to those of normal sheep menisci without fissures and lacerations; the control specimens had these defects. The femoral and tibial cartilage in contact with the new menisci had normal surface characteristics apart from one animal with slight surface irregularities. Control animals showed superficial lesions after three months which increased at six to 12 months postoperatively. Microangiography of the newly grown tissue demonstrated a less intense vascularisation after three months when compared with normal menisci.The failure stress and tensile modulus of perichondral menisci were significantly lower than those of normal contralateral menisci, and spontaneously regenerated tissue in meniscectomised animals had even lower values. There were no significant differences in values between newly grown perichondral menisci and spontaneously grown tissue. [Br] 1998;80-B:918-23. J Bone Joint Surg

PLDLA/PCL-T Scaffold for Meniscus Tissue Engineering

“…5 The use of natural autologous materials for this purpose has yielded unsatisfactory results because of unfavorable mechanical properties and the difficulty in obtaining these natural substitutes. 6–8 With regard to the use of prostheses, there are still no artificial materials with mechanical properties similar to those of the original meniscus. 9 Although nonabsorbable synthetic materials allow cell invasion, collagen I and II deposition, and the formation of new tissue with fibrochondrocyte-like characteristics, 10 they are unable to confer long-term protection to articular cartilage after long periods.…”

What tissue bankers should know about the use of allograft meniscus in orthopaedics

“…In the past, various tissues have been used in an attempt to replace missing meniscal tissue, including autologous tissues such as patellar, Achilles or semitendinosus tendon autograft (Johnson and Feagin 2000;Kohn 1993;Kohn et al 1992), fat pad autograft (Kohn et al 1997) and autologous rib perichondral grafts (Bruns et al 1998), as well as synthetic silastic (Kenny et al 1983), carbon fibre (Veth et al 1983), Dacron (Sommerlath and Gillquist 1992) and Teflon (Messner 1994) prostheses. These various innovations have, unfortunately, met fairly universally with poor results.…”

Autogener Meniskusersatz mittels Rippenperichondrium

“…Die Fixation erfolgte durch nichtresorbierbare Nähte an die verbliebenen Meniskushaltebän-der im Bereich der Vorder-und Hinterhörner. Auûerdem wurde der Perichondriumstreifen mit einer fortlaufenden Naht an der Kapsel fixiert [10] (Abb. 1).…”

“…Drei, 6 und 12 Monate postoperativ wurden je 4 Tiere mit Transplantat und 2 Kontrolltiere getötet und das transplantierte bzw. spontan entstandene Gewebe sowie die angrenzenden Gelenkflächenareale wie bereits beschrieben [10] entnommen, aufgeteilt und histologisch, polarisationsoptisch, rasterelektronenmikroskopisch und biomechanisch (Bestimmung der Reiûfestigkeit) analysiert. Exemplarisch erfolgte eine MRT-sowie Angiographieuntersuchung.…”

“…Exemplarisch erfolgte eine MRT-sowie Angiographieuntersuchung. Die eingehende Darstellung der Untersuchungstechniken ist in der Originalarbeit [10] beschrieben worden.…”