title: Stem cell based tissue engineering for meniscus repair.
abstract: Defects of the meniscus greatly alter knee function and predispose the joint to degenerative changes. The purpose of this study was to test a recently developed cell-scaffold combination for the repair of a critical-size defect of the rabbit medial meniscus. A bilateral, complete resection of the pars intermedia of the medial meniscus was performed in 18 New Zealand White rabbits. A hyaluronan/gelatin composite scaffold was implanted into the defect of one knee of 6 rabbits and the contralateral defect was left untreated. Scaffolds loaded with autologous marrow-derived mesenchymal stem cells and cultured in a chondrogenic medium for 14 days were implanted in a second series of 12 rabbits. Empty scaffolds were implanted in the contralateral knees. Meniscii were harvested at 12 weeks. Untreated defects had a muted fibrous healing response. Defects treated with cell-free implants showed also predominantly fibrous tissue whereas fibrocartilage was present in some scaffolds. The cross-sectional width of the repair tissue after treatment with cell-free scaffolds was significantly greater than controls (p < 0.05). Pre-cultured implants integrated with the host tissue and 8 of 11 contained meniscus-like fibrocartilage, compared with 2 of 11 controls (p < 0.03). The mean cross-sectional width of the pre-cultured implant repair tissue was greater than controls (p < 0.004). This study demonstrates the repair of a critical size meniscal defect with a stem cell and scaffold based tissue engineering approach.
authors.affiliation: Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio 44106, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Angele
authors.forename: Brian
authors.initials: B
authors.lastname: Johnstone
authors.forename: Richard
authors.initials: R
authors.lastname: Kujat
authors.forename: Johannes
authors.initials: J
authors.lastname: Zellner
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
authors.forename: Victor
authors.initials: V
authors.lastname: Goldberg
authors.forename: Jung
authors.initials: J
authors.lastname: Yoo
mesh_terms: D000818:Animals; D007718:Knee Injuries / Q000628:therapy*; D008297:Male; D008592:Menisci, Tibial / Q000166:cytology*; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D011817:Rabbits; D000070600:Tibial Meniscus Injuries; D023822:Tissue Engineering