First Clinical Application of Polyurethane Meniscal Scaffolds with Mesenchymal Stem Cells and Assessment of Cartilage Quality with T2 Mapping at 12 Months

Abstract

Background Complex meniscal lesions often require meniscectomy with favorable results in the short term but a high risk of early osteoarthritis subsequently. Partial meniscectomy treated with meniscal substitutes may delay articular cartilage degeneration. Purpose To evaluate the status of articular cartilage by T2 mapping after meniscal substitution with polyurethane scaffolds enriched with mesenchymal stem cells (MSC) and comparison with acellular scaffolds at 12 months. Methods Seventeen patients (18-50 years) with past meniscectomies were enrolled in 2 groups: (1) acellular polyurethane scaffold (APS) or (2) polyurethane scaffold enriched with MSC (MPS). Patients in the MPS group received filgrastim to stimulate MSC production, and CD90+ cells were obtained and cultured in the polyurethane scaffold. The scaffolds were implanted arthroscopically into partial meniscus defects. Concomitant injuries (articular cartilage lesions or cartilage lesions) were treated during the same procedure. Changes in the quality of articular cartilage were evaluated with T2 mapping in femur and tibia at 12 months. Results In tibial T2 mapping, values for the MPS group increased slightly at 9 months but returned to initial values at 12 months ( P > 0.05). In the APS group, a clear decrease from 3 months to 12 months was observed ( P > 0.05). This difference tended to be significantly lower in the APS group compared with the MPS group at the final time point ( P = 0.18). In the femur, a slight increase in the MPS group (47.8 ± 3.4) compared with the APS group (45.3 ± 4.9) was observed ( P > 0.05). Conclusion Meniscal substitution with polyurethane scaffold maintains normal T2 mapping values in adjacent cartilage at 12 months. The addition of MSC did not show any advantage in the protection of articular cartilage over acellular scaffolds ( P > 0.05).

Rational design of biodegradable thermoplastic polyurethanes for tissue repair

“…In Monllau's study, PU scaffold resorption and the incomplete in-growth of new meniscus-like tissue was observed [ 267 ]. Recently, the first clinical report of PU meniscal scaffolds with MSCs was published [ 268 ]. Seventeen patients (18–50 years old) with past meniscectomies were separated into two groups: acellular PU scaffold and MSC-enriched PU scaffold.…”

Validation of the 1,4‐butanediolthermoplastic polyurethane as a novel material for3Dbioprinting applications

“…In fact, polyurethane-based materials are already being tested in clinical trials. 49,50 3D bioprinting technology allows us to fabricate b-TPUe scaffolds with the desired thickness of fiber and pore size, biomimicking the tissue microstructure, and thus ameliorating the integration of the scaffold within the specific location. The porosity and interconnectivity of the scaffold plays a significant role in nutrient supply, gas diffusion and metabolic waste removal.…”

Meniscal Regenerative Scaffolds Based on Biopolymers and Polymers: Recent Status and Applications

“…However, this advantage of MSC loading disappeared after 12 weeks ( Koch et al, 2018 ). It has also been reported that MSC-seeded PU scaffolds exhibit little additional clinical benefit in the protection of articular cartilage ( Olivos-Meza et al, 2019 ).…”