Stem cell-based tissue-engineering for treatment of meniscal tears in the avascular zone

Abstract

Meniscal tears in the avascular zone have a poor self-healing potential, however partial meniscectomy predisposes the knee for early osteoarthritis. Tissue engineering with mesenchymal stem cells and a hyaluronan collagen based scaffold is a promising approach to repair meniscal tears in the avascular zone. 4 mm longitudinal meniscal tears in the avascular zone of lateral menisci of New Zealand White Rabbits were performed. The defect was left empty, sutured with a 5-0 suture or filled with a hyaluronan/collagen composite matrix without cells, with platelet rich plasma or with autologous mesenchymal stem cells. Matrices with stem cells were in part precultured in chondrogenic medium for 14 days prior to the implantation. Menisci were harvested at 6 and 12 weeks. The developed repair tissue was analyzed macroscopically, histologically and biomechanically. Untreated defects, defects treated with suture alone, with cell-free or with platelet rich plasma seeded implants showed a muted fibrous healing response. The implantation of stem cell-matrix constructs initiated fibrocartilage-like repair tissue, with better integration and biomechanical properties in the precultured stem cell-matrix group. A hyaluronan-collagen based composite scaffold seeded with mesenchymal stem cells is more effective in the repair avascular meniscal tear with stable meniscus-like tissue and to restore the native meniscus.

Synovial mesenchymal stem cells promote healing after meniscal repair in microminipigs

“…Histological pictures were taken by light microscopy (Olympus IX71). The histology was scored on a modified scoring system based on that developed by Zellner et al 30 . The repair was graded by summing up the scores from 0 to 3 of 6 individual subgroups.…”

Application of cell and biomaterial-based tissue engineering methods in the treatment of cartilage, menisci and ligament injuries

“…In a rabbit model of meniscus defect, MSCs seeded on hyaluronan/gelatine matrices and implanted to the injury site, integrated well with the host tissue, filled the defect and three months, newly formed fibrocartilage, with hyaline-like cartilage zones, was observed [82]. In a more recent study, Zellner et al [84] compared the effects of repairing meniscus tears in the avascular zone of rabbits using four different treatment methods: untreated tear, suture of the meniscus, a PRPloaded composite and a scaffold loaded with autologous MSCs. At 12 weeks, no signs of healing were observed in either the untreated or sutured tear groups.…”

“…In the TE of the meniscus, HA was used as a scaffold composite together with gelatine [82], collagen [83,84] and PCL [85]. In a rabbit model of meniscus defect, MSCs seeded on hyaluronan/gelatine matrices and implanted to the injury site, integrated well with the host tissue, filled the defect and three months, newly formed fibrocartilage, with hyaline-like cartilage zones, was observed [82].…”

Animal Models of Meniscal Injury in Post-Traumatic Arthritis

“…By 9 months, OA is identifi ed on all cartilage surfaces [ 78 ], and at 11 months, range of motion in extension may be limited by 10°-25° [ 79 ]. Likewise, in the lateral meniscus, 4 mm longitudinal lesions in the avascular zone of the pars intermedia fail to heal [ 80 ]. In the posterior horn longitudinal tears in the avascular zone only partially heal by 6-12 weeks, and the reparative tissue has tear load propagation resistance only 20-25 % of that of control tissue [ 81 ].…”