title: Tissue engineering techniques for the treatment of a complex knee injury.
abstract: We report and discuss the use of and rationale for tissue engineering techniques in a 40-year-old sportsman who suffered simultaneous anterior cruciate ligament (ACL) rupture, irreparable medial meniscal tear, and chondral lesion of the medial femoral condyle. A 2-step treatment was adopted to address all lesions. The first procedures consisted of ACL reconstruction and collagen meniscus implant (CMI), followed 6 months later by autologous chondrocyte implantation on a collagen membrane (MACI). A CMI biopsy was performed 6 months after implantation. Histologic and ultrastructural analysis documented scaffold invasion by cells and newly synthesized connective tissue. At 2-year follow up, the clinical and functional results were good and magnetic resonance imaging showed integration of the meniscal and cartilage implants. In this patient, each lesion needed to be addressed to achieve an optimal outcome. The primary goal was to restore normal joint biomechanics by performing CMI and ACL reconstruction. MACI was an adequate solution for the management of the large (5 cm(2)) chondral defect.
authors.affiliation: Department of Orthopaedics and Traumatology M. Boni, the University of Insubria, Varese, Italy. mario.ronga@uninsubria.it
authors.forename: Mario
authors.initials: M
authors.lastname: Ronga
authors.forename: Federico Alberto
authors.initials: FA
authors.lastname: Grassi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Manelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Bulgheroni
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D002358:Cartilage, Articular / Q000293:injuries*; D019902:Chondrocytes / Q000637:transplantation; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D012916:Soccer / Q000293:injuries; D000070600:Tibial Meniscus Injuries; D023822:Tissue Engineering