Replacement of the Knee Meniscus by a Porous Polymer Implant

American Journal of Sports Medicine - Tập 34 Số 1 - Trang 64-71 - 2006
Tony G. van Tienen1, R. G. J. C. Heijkants2, J. H. de Groot2, A. J. Pennings2, A. J. Schouten2, R.P.H. Veth1, Pieter Buma1
1Orthopaedic Research Laboratory, Department of Orthopaedics, University Medical Center Nijmegen, Nijmegen, the Netherlands
2Department of Polymer Chemistry, State University of Groningen, Groningen, the Netherlands

Tóm tắt

BackgroundMeniscectomy will lead to articular cartilage degeneration in the long term. Therefore, the authors developed an implant to replace the native meniscus.HypothesisThe porous polymer meniscus implant develops into a neomeniscus and protects the cartilage from degeneration.Study DesignControlled laboratory study.MethodsIn a dog model, a porous polymer scaffold with optimal properties for tissue infiltration and regeneration of a neomeniscus was implanted and compared with total meniscectomy. The tissue infiltration and redifferentiation in the scaffold, the stiffness of the scaffold, and the articular cartilage degeneration were evaluated.ResultsThree months after implantation, the implant was completely filled with fibrovascular tissue. After 6 months, the central areas of the implant contained cartilage-like tissue with abundant collagen type II and proteoglycans in their matrix. The foreignbody reaction remained limited to a few giant cells in the implant. The compression modulus of the implant-tissue construct still differed significantly from that of the native meniscus, even at 6 months. Cartilage degeneration was observed both in the meniscectomy group and in the implant group.ConclusionThe improved properties of these polymer implants resulted in a faster tissue infiltration and in phenotypical differentiation into tissue resembling that of the native meniscus. However, the material characteristics of the implant need to be improved to prevent degeneration of the articular cartilage.Clinical RelevanceThe porous polymer implant developed into a polymer-tissue construct that resembled the native meniscus, and with improved gliding characteristics, this prosthesis might be a promising implant for the replacement of the meniscus.

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Thông tin
Thông tin xuất bản

American Journal of Sports Medicine

Tập 34 Số 1

64-71

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