Purpose: Prevention of the knee osteoarthritis following meniscectomy is implantation of an allotransplant or an artificial meniscus. We present retrospective study of our early results of the treatment using polyurethane meniscal scaffold.
Methods: From 2016 to 2020, we implanted nine polyurethane scaffolds (Actifit) after partial meniscectomy, five males and four females, age 36 (16-47), BMI 26.7 (17.2-35.9) kg/m. Functional status, activity, pain, and MRI were assessed.
Results: FU 20.8 (6-48.5) months, 35.2 (0-68) months from the meniscectomy to the implantation. The average implant length was 46.1 (35-60) mm, average number of sutures was 7.6 (5-10). Lysholm score before surgery was 61.7 (49-85), after the surgery 86.4 (62-95) with p 0.0045, Tegner activity score before meniscectomy was 5.8 (4-7), after 3.8 (2-5), and after the scaffold implantation 4.6 (3-7) with p 0.0488. Before surgery, VAS score was 3.1 (2-4), and after 7.7 (5-9) with p 0.0042. Pursuant to the Genovese classification, the last follow-up MRI showed a type 2 meniscal morphology in four cases and a type 3 in five cases. Seven patients had type 1 and two had type 2 signal intensity. On average, the absolute extrusion of a transplanted meniscus was 3.67 mm, and the relative extrusion was 0.58 mm. Extrusion progress was not detected.
Conclusion: Significantly improved knee functionality, increased level of physical activity, and reduced pain. MRI analysis revealed the meniscal transplant morphology and volume loss, as well as its extrusion without progression.
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http://dx.doi.org/10.1007/s00264-020-04844-y | DOI Listing |
J Mech Behav Biomed Mater
February 2025
Centre for Regenerative Medicine, Department for Health Science, University for Continuing Education Krems, Krems an der Donau, Austria; Austrian Cluster for Tissue Regeneration, Austria.
Objective: To investigate the suitability of different material compositions and structural designs for 3D-printed meniscus implants using finite element analysis (FEA) to improve joint function after meniscal injury and guide future implant development.
Design: This experimental study involved in-silico testing of a meniscus model developed from two materials: a specially formulated hydrogel composed of silk fibroin (SF), gelatine, and decellularized meniscus-derived extracellular matrix (MD-dECM), and polyurethane (PU) with stiffness levels of 54 and 205 MPa. Both single-material implants and a two-volumetric meniscus model with an SF/gelatine/MD-dECM core and a PU shell were analysed using FEA to simulate the biomechanical performance under physiological conditions.
J Orthop
October 2024
University of Montreal, 2900 Boul. Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada.
Biomater Sci
May 2024
IBMM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
Focusing on the regeneration of damaged knee meniscus, we propose a hybrid scaffold made of poly(ester-urethane) (PEU) and collagen that combines suitable mechanical properties with enhanced biological integration. To ensure biocompatibility and degradability, the degradable PEU was prepared from a poly(ε-caprolactone), L-lysine diisocyanate prepolymer (PCL di-NCO) and poly(lactic--glycolic acid) diol (PLGA). The resulting PEU ( = 52 000 g mol) was used to prepare porous scaffolds using the solvent casting (SC)/particle leaching (PL) method at an optimized salt/PEU weight ratio of 5 : 1.
View Article and Find Full Text PDFCurr Rev Musculoskelet Med
July 2024
Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, 5841 S. Maryland Ave MC 3079, Chicago, IL, 60637, USA.
Purpose Of Review: The limited blood supply and intrinsic healing capacity of the meniscus contributes to suboptimal tissue regeneration following injury and surgical repair. Biologic augmentation techniques have been utilized in combination with isolated meniscal repair to improve tissue regeneration. Several innovative strategies such as Platelet-Rich Plasma (PRP), fibrin clots, mesenchymal stem cells (MSCs), bone marrow stimulation, meniscal scaffolds, and meniscal wrapping, are being explored to enhance repair outcomes.
View Article and Find Full Text PDFMolecules
February 2024
IBMM, Univ Montpellier, CNRS, ENSCM, 34000 Montpellier, France.
To develop an orthopedic scaffold that could overcome the limitations of implants used in clinics, we designed poly(ester-urethane) foams and compared their properties with those of a commercial gold standard. A degradable poly(ester-urethane) was synthetized by polyaddition between a diisocyanate poly(ε-caprolactone) prepolymer (PCL di-NCO, = 2400 g·mol) and poly(lactic--glycolic acid) diol (PLGA, = 2200 g·mol) acting as a chain extender. The resulting high-molecular-weight poly(ester-urethane) (PEU, = 87,000 g·mol) was obtained and thoroughly characterized by NMR, FTIR and SEC-MALS.
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