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Meniscal Repair Supplemented With Exogenous Fibrin Clot and Autogenous Cultured Marrow Cells in the Goat Model

Orthopaedic Research Institute at the Southern California Center for Sports Medicine and Long Beach Memorial Medical Center

Douglas W. Jackson, MD

Orthopaedic Research Institute at the Southern California Center for Sports Medicine and Long Beach Memorial Medical Center

Thay Q. Lee, MS

Orthopaedic Biomechanics Laboratory, Veterans Administration Medical Center, Long Beach, California

Timothy M. Simon, MS

Orthopaedic Research Institute at the Southern California Center for Sports Medicine and Long Beach Memorial Medical Center

This study was undertaken to evaluate the placement of fibrin clot and cultured autologous marrow cells in surgically created, full-thickness, meniscal lesions in the avascular zone in 32 female Spanish goats. The menisci were repaired with two vertically oriented su tures (N = 8), exogenous fibrin clot was placed into the meniscal defect before placement of the two sutures (N = 8), fibrin clot plus cultured adherent bone marrow cells were placed in the defect (N = 8), or the meniscal lesions were left unrepaired (N = 8). On gross and manual inspection, meniscal lesions showed some de gree of healing in all animals except for the eight unrepaired lesions. All the experimental specimens had decreased tensile strength compared with the con tralateral control medial menisci. Ultimate load to fail ure, energy absorbed to failure, and stiffness were less than 40% of the controls for all groups. Histologic sections demonstrated focal cellular areas consisting of giant cells and macrophages in the repair sites. Our observations failed to demonstrate a statistically signif icant enhancement of healing with the use of exoge nous fibrin clot compared with vertically oriented su tures alone. The addition of cultured adherent autologous bone marrow-derived cells in conjunction with the fibrin clot did not enhance the meniscal healing.

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