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.

New algorithm for selecting meniscal allografts that best match the size and shape of the damaged meniscus

“…28 Of these, only collagen scaffolds have been tested in humans to date with some promising results, 22 while the others are more preliminary with testing restricted to animal models. Any of these options or other replacement option(s) may likely emerge as viable tissue engineering options.…”

Meniscus repair and regeneration: review on current methods and research potential

“…Natural materials used to date are: periosteal tissue (Walsh et al, 1999); perichondral tissue (Bruns et al, 1998); small intestine submucosa (SIS) (Cook et al, 1999); acellular porcine meniscal tissue (Stapleton et al, 2008); and bacterial cellulose (Bodin et al, 2007). While these tissues have high biocompatibility, some of them cannot be employed for tissue engineering techniques as they do not allow varying structure geometry and initial mechanical properties .…”

Passive Strain-Induced Matrix Synthesis and Organization in Shape-Specific, Cartilaginous Neotissues

“…[15][16][17][18] Such scaffolds, however, have been found to exhibit insufficient biomechanical integrity, particularly in the case of naturally derived fibers. 19,20 Scaffolds also suffer from biodegradability and biocompatibility issues, as especially seen with synthetic scaffolds. [21][22][23] Further, it has been suggested that use of any scaffolding material may hinder both cellular communication and responsiveness to external stresses.…”