Journal
AMERICAN JOURNAL OF SPORTS MEDICINE
Volume 46, Issue 8, Pages 1844-1856Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0363546517752668
Keywords
knee; meniscus; tissue engineering; biomechanics; general
Categories
Funding
- Armed Forces Institute for Regenerative Medicine II (AFIRM II) [W81XWH-08-2-0034]
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Background: Meniscus injuries and associated meniscectomies cause patients long-term pain and discomfort and can lead to joint deterioration. Purpose: To evaluate a collagen-hyaluronan sponge reinforced with synthetic resorbable polymer fiber for total meniscus reconstruction in a long-term ovine model. Study Design: Controlled laboratory study. Methods: Eleven skeletally mature sheep were implanted with the total meniscus scaffold. At 2 years, explants were evaluated biologically (radial/circumferential histology, immunofluorescence) and mechanically (compression, tension), and articular surfaces were examined for damage. Results: The fiber-reinforced scaffold induced formation of functional neomeniscus tissue that was intact in 8 of 11 animals. The implant was remodeled into organized circumferentially aligned collagen bundles to resist meniscus hoop stresses. Moreover, type II collagen and proteoglycan deposition near the inner margin suggested a direct response to compressive stresses and confirmed fibrocartilage formation. Cartilage damage was observed, but end-stage (severe) joint deterioration associated with meniscectomy was avoided, even with limitations regarding the ovine surgical procedure and postoperative care. Conclusion: A fiber-reinforced total meniscus replacement device induces formation of functional neomeniscus tissue that has the potential to prevent catastrophic joint deterioration associated with meniscectomy.
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