Journal
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
Volume 17, Issue 2, Pages 151-159Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/jars.2001.20959
Keywords
meniscus; meniscal regeneration; meniscal repair; animal study; collagenous graft; small intestine submucosa
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Purpose: The present investigation is a preliminary study designed to evaluate the use of a collagen-based biomaterial, chemically unaltered porcine small intestine submucosa (SIS), as a scaffold for meniscal tissue regeneration. Type of Study: Basic research. Methods: Surgical defects were created in the lateral menisci of 12 mature New Zealand white rabbits. The defects were repaired with a similarly shaped and sized wedge of a new collagenous biomaterial (SIS) and sutured in place. The opposite knees served as controls by creating a defect in the lateral meniscus without filling with SIS graft. Full cage activity was allowed until the animals were killed at 4, 12, and 24 weeks. Results: At 4 weeks, the graft material retained its physical position and grossly appeared soft and translucent. Histologically, cellular elements had infiltrated between the laminates of the graft. At 12 weeks, the graft grossly appeared more solid and opaque. Histologically, the host meniscal fibrochondrocytes were seen streaming into the peripheral margin of the graft. Early repopulation of the graft with apparently differentiated meniscal tissue was observed. At 24 weeks, the meniscus defect was grossly healed across and looked virtually normal: the normal meniscal shape, contour, consistency, and color had been replicated. Histologically, the healing tissue showed infiltration of what appeared to be meniscal fibrochondrocytes and connective tissue resembling the host meniscal tissue. The graft was nearly totally replaced by host tissue. Conclusions: This pilot animal study demonstrates that the multilaminated collagenous graft is conducive for cellular repopulation with host meniscal elements, and, by 24 weeks, is capable of supporting complete healing of a large meniscal defect.
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