The effect of a meniscal prosthesis on knee biomechanics and cartilage

Sommerlath, Karola; Gillquist, Jan

doi:10.1177/036354659202000117

Cited by 81 publications

(16 citation statements)

References 26 publications

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“…It has been accepted that meniscal lesions in the vascularized portion of the meniscus heal, whereas lesions in the avascular portion of the meniscus do not repair 28–30. Numerous strategies to repair and replace the meniscus have achieved only limited success 31–35. In a previous study, we achieved a successful repair of large meniscal defects that included both the vascular and avascular zones using a mesenchymal stem cell‐matrix combination 7.…”

Section: Introductionmentioning

confidence: 94%

Role of mesenchymal stem cells in tissue engineering of meniscus

Zellner

Mueller

Berner

et al. 2010

J Biomedical Materials Res

159

179

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Tissue engineering is a promising approach for the treatment of tissue defects. Mesenchymal stem cells are of potential use as a source of repair cells or of important growth factors for tissue engineering. The purpose of this study was to examine the role of mesenchymal stem cells in meniscal tissue repair. This was tested using several cell and biomaterial-based treatment options for repair of defects in the avascular zone of rabbit menisci. Circular meniscal punch defects (2 mm) were created in the avascular zone of rabbit menisci and left empty or filled with hyaluronan-collagen composite matrices without cells, loaded with platelet-rich plasma, autologous bone marrow, or autologous mesenchymal stem cells. In some experiments, matrices with stem cells were precultured in chondrogenic medium for 14 days before implantation. Rabbits were then allowed free cage movement after surgery for up to 12 weeks. Untreated defects and defects treated with cell-free implants had muted fibrous healing responses. Neither bone marrow nor platelet-rich plasma loaded in matrices produced improvement in healing compared with cell-free implants. The implantation of 14 days precultured chondrogenic stem cell-matrix constructs resulted in fibrocartilage-like repair tissue, which was only partially integrated with the native meniscus. Non-precultured mesenchymal stem cells in hyaluronan-collagen composite matrices stimulated the development of completely integrated meniscus-like repair tissue. The study shows the necessity of mesenchymal stem cells for the repair of meniscal defects in the avascular zone. Mesenchymal stem cells seem to fulfill additional repair qualities besides the delivery of growth factors.

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Section: Introductionmentioning

confidence: 94%

Role of mesenchymal stem cells in tissue engineering of meniscus

Zellner

Mueller

Berner

et al. 2010

J Biomedical Materials Res

159

179

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“…In the medial compartment, degenerative changes appear to be proportional to the amount of menisci removed and the postoperative period. Several in vivo studies demonstrated that chondral lesions appear earlier and more intensively in the tibial plateau than in the femoral condyle 7, 8. Therefore, a medial meniscectomy in animals is frequently used as a model for knee osteoarthritis 9…”

mentioning

confidence: 99%

Replacement of the medial tibial plateau by a metallic implant in a goat model

et al. 2009

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The purposes of the present study were to explore the surgical possibilities for replacement of the medial tibial plateau by a metallic implant in a large animal model and to examine the implications for the opposing cartilage. In six goats, the medial tibial plateau of the right knee was replaced by a cobalt-chromium implant, using polymethylmethacrylate bone cement for fixation. The unoperated left knee served as a control. At 26 weeks after surgery, the animals were killed, and the joints evaluated macroscopically. Cartilage quality was analyzed macroscopically and histologically. Glycosaminoglycan content, synthesis, and release were measured in tissue and medium. All animals were able to move and load the knees without any limitations. Macroscopic articular evaluation scores showed worsening 26 weeks after inserting the implant (p < 0.05). Macroscopic and histologic scores showed more cartilage degeneration of the opposing medial femoral condyle in the experimental knee compared to the control knee (p < 0.05). Higher glycosaminoglycan synthesis was measured at the medial femoral condyle cartilage in the experimental knees (p < 0.05). This study shows that the medial tibial plateau can be successfully replaced by a cobalt-chromium implant in a large animal model. However, considerable femoral cartilage degeneration of the medial femoral condyle was induced, suggesting that care must be taken introducing hemiarthroplasty devices in a human clinical setting for the treatment of postmeniscectomy cartilage degeneration of the medial tibial plateau. ß

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“…The first study on the rabbit model dates back to 1992 [ 21 ], when a Dacron meniscus prosthesis with polyurethane coating was used. Results of this trial were fairly negative, since poor tissue healing was observed, with low scaffold integration, and the meniscal substitute did not prevent cartilage degeneration with respect to the meniscectomized control group.…”

Section: Resultsmentioning

confidence: 99%

Meniscal Scaffolds - Preclinical Evidence to Support their Use: A Systematic Review

Matteo¹,

Perdisa²,

Gostynska³

et al. 2015

TOORTHJ

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Arthroscopic meniscal treatment is the most common procedure performed in the orthopedic practice. Current management of meniscal pathology relies on different therapeutic options, ranging from selective meniscectomy, suturing, and to meniscal replacement by using either allografts or scaffolds. The progresses made in the field of regenerative medicine and biomaterials allowed to develop several meniscal substitutes, some of those currently used in the clinical practice. Before reaching the clinical application, these devices necessarily undergo accurate testing in the animal model: the aim of the present manuscript is to systematically review the scientific evidence derived by animal model results for the use of meniscal scaffolds, in order to understand the current state of research in this particular field and to identify the trends at preclinical level that may influence in the near future the clinical practice.Thirty-four papers were included in the present analysis. In 12 cases the meniscal scaffolds were used with cells to further stimulate tissue regeneration. With the exception of some negative reports regarding dacron-based scaffolds, the majority of the trials highlighted that biomaterials and bio-engineered scaffolds are safe and could play a beneficial role in stimulating meniscal healing and in chondral protection. With regard to the benefits of cell augmentation, the evidence is limited to a small number of studies and no conclusive evidence is available. However, preclinical evidence seems to suggest that cells could enhance tissue regeneration with respect to the use of biomaterials alone, and further research should confirm the translational potential of cell-based approach.

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The effect of a meniscal prosthesis on knee biomechanics and cartilage

Cited by 81 publications

References 26 publications

Role of mesenchymal stem cells in tissue engineering of meniscus

Role of mesenchymal stem cells in tissue engineering of meniscus

Replacement of the medial tibial plateau by a metallic implant in a goat model

Meniscal Scaffolds - Preclinical Evidence to Support their Use: A Systematic Review

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