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This Article Full Text Free Full Text (PDF) Free All Versions of this Article: 34/1/64    most recent 0363546505280905v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Tienen, T. G. Articles by Buma, P. Search for Related Content PubMed PubMed Citation Articles by Tienen, T. G. Articles by Buma, P. Related Collections Knee Meniscus Animal studies

Replacement of the Knee Meniscus by a Porous Polymer Implant

A Study in Dogs

Tony G. Tienen, MD^*,, Ralf G. J. C. Heijkants, Jacqueline H. de Groot, PhD, Albert J. Pennings, PhD, Arend Jan Schouten, PhD, Rene P. H. Veth, MD, PhD and Pieter Buma, PhD

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

^* Address correspondence to Tony G. Tienen, MD, Orthopaedic Research Laboratory, Department of Orthopaedics, University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands (e-mail: t.vantienen{at}orthop.umcn.nl).

Background: Meniscectomy will lead to articular cartilage degeneration in the long term. Therefore, the authors developed an implant to replace the native meniscus.

Hypothesis: The porous polymer meniscus implant develops into a neomeniscus and protects the cartilage from degeneration.

Study Design: Controlled laboratory study.

Methods: In 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.

Results: Three 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 foreign-body 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.

Conclusion: The 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 Relevance: The 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.

Key Words: meniscus • animal study • prosthesis • polymer

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