Autogenous replacement of the meniscus cartilage: analysis of results and mechanisms of failure.
Autogenous replantation of meniscal cartilage (resection of 80% of the meniscus cartilage followed by immediate replantation) was performed in 14 dogs as a control arm of a meniscal replacement study. The purpose was to assess the ability of the excised tissue to heal to the intact rim and function as a meniscus cartilage. This procedure is an idealized model of allografting meniscus cartilage in that the tissue is fresh, autogenous, and perfectly sized. If this procedure did not succeed, it seemed likely to the authors that allografting meniscal cartilage would have diminished chances for success. Evaluation of these replant failures led us to speculate that the causes and mechanisms might include slow or incomplete revascularization, inadequate mechanical fixation or stabilization, and, perhaps, some type of rejection phenomenon not examined or confirmed in the present study. We believe these mechanisms will be particularly deleterious for allografted meniscal cartilages and recommend further extensive evaluation of meniscal allografts before wide clinical use.
Stone
K R
KR
Letterman Army Institute of Research, San Francisco, California, USA.
Rodkey
W G
WG
McKinney
L A
LA
Steadman
J R
JR
D000818:Animals; D004285:Dogs; D005260:Female; D006085:Graft Survival; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D011859:Radiography; D014182:Transplantation, Autologous / Q000379:methods