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Prosthetic Replacement of the Medial Meniscus in Cadaveric Knees

Does the Prosthesis Mimic the Functional Behavior of the Native Meniscus?

T. G. Tienen, MD^*, N. Verdonschot, PhD^,*, R. G. J. C. Heijkants, P. Buma, PhD^*, J. G. F. Scholten, MD^*, A. van Kampen, MD, PhD^* and R. P. H. Veth, MD, PhD^*

From the ^* Orthopaedic Research Laboratory, University Medical Center Nijmegen, Nijmegen, the Netherlands, and the Department of Polymer Chemistry, University of Groningen, Groningen, the Netherlands

Address correspondence to N. Verdonschot, Department of Orthopaedics, University Medical Center Nijmegen, Nijmegen, the Netherlands, PO Box 9101, 6500 HB Nijmegen, the Netherlands (e-mail: N.Verdonschot{at}orthop.umcn.nl).

Abstract: Meniscus replacement by a polymer meniscus prosthesis in dogs resulted in generation of new meniscal tissue.

Hypothesis: Optimal functioning of the prosthesis would involve realistic deformation and motion patterns of the prosthesis during knee joint motion.

Study Design: Controlled laboratory study.

Methods: The movements of the meniscus were determined during knee joint flexion and extension with and without internal and external tibial torque by means of roentgen stereophotogrammetric analysis. Subsequently, the meniscus in 6 human cadaveric knee joints was replaced by a meniscus prosthesis.

Results: All different parts of the meniscus showed a posterior displacement during knee joint flexion. The anterior horn was more mobile than the posterior horn. The prosthesis mimicked the movements of the meniscus. However, the excursions of the prosthesis on the tibial plateau were less. The knee joint laxity was not significantly higher after replacement with the meniscus prosthesis.

Conclusions: The prosthesis approximated the behavior of the native meniscus. Improvement in both the gliding characteristics of the prosthetic material and the fixation of the prosthesis may improve the function.

Clinical Relevance: The meniscus prosthesis needs to be optimized to achieve a better initial function in the knee joint.

Key Words: trauma • meniscus replacement • roentgen stereophotogrammetric analysis (RSA) • polymer

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