title: One-Year Outcomes of Total Meniscus Reconstruction Using a Novel Fiber-Reinforced Scaffold in an Ovine Model.
abstract: BACKGROUND
  Meniscus injuries and resulting meniscectomies lead to joint deterioration, causing pain, discomfort, and instability. Tissue-engineered devices to replace the meniscus have not shown consistent success with regard to function, mechanical integrity, or protection of cartilage.
  
  
  OBJECTIVE
  To evaluate a novel resorbable polymer fiber-reinforced meniscus reconstruction scaffold in an ovine model for 52 weeks and assess its integrity, tensile and compressive mechanics, cell phenotypes, matrix organization and content, and protection of the articular cartilage surfaces.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Eight skeletally mature ewes were implanted with the fiber-reinforced scaffold after total meniscectomy, and 2 additional animals had untreated total meniscectomies. Animals were sacrificed at 52 weeks, and the explants and articular surfaces were analyzed macroscopically. Explants were characterized by ultimate tensile testing, confined compression creep testing, and biochemical, histological, and immunohistochemical analyses. Cartilage damage was characterized using the Mankin score on histologic slides from both the femur and tibia.
  
  
  RESULTS
  One sheep was removed from the study because of a torn extensor tendon; the remaining 7 explants remained fully intact and incorporated into the bone tunnels. All explants exhibited functional tensile loads, tensile stiffnesses, and compressive moduli. Fibrocartilagenous repair with both types 1 and 2 collagen were observed, with areas of matrix organization and biochemical content similar to native tissue. Narrowing in the body region was observed in 5 of 7 explants. Mankin scores showed less cartilage damage in the explant group (femoral condyle: 3.43 ± 0.79, tibial plateau: 3.50 ± 1.63) than in the meniscectomy group (femoral condyle: 8.50 ± 3.54, tibial plateau: 6.75 ± 2.47) and were comparable with Mankin scores at the previously reported 16- and 32-week time points.
  
  
  CONCLUSIONS
  A resorbable fiber-reinforced meniscus scaffold supports formation of functional neomeniscus tissue, with the potential to prevent joint degeneration that typically occurs after total meniscectomy. Further studies with improvements to the initial mechanics of the scaffold and testing for longer time periods are warranted.
  
  
  CONCLUSIONS
  Meniscectomy is an extremely common orthopaedic procedure, and few options currently exist for the treatment of significant loss of meniscus tissue. Successful development of a tissue-engineered meniscus scaffold could substantially reduce the incidence of postmeniscectomy joint degeneration and the subsequent procedures used for its treatment.
authors: Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA Department of Biomedical Engineering, Rutgers-The State University of New Jersey, Piscataway, New Jersey, USA.
authors: Jay M
authors: JM
authors: Patel
authors: Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA Department of Biomedical Engineering, Rutgers-The State University of New Jersey, Piscataway, New Jersey, USA.
authors: Aaron R
authors: AR
authors: Merriam
authors: Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors: Brian M
authors: BM
authors: Culp
authors: Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA Department of Biomedical Engineering, Rutgers-The State University of New Jersey, Piscataway, New Jersey, USA.
authors: Charles J
authors: CJ
authors: Gatt
authors: Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA Department of Biomedical Engineering, Rutgers-The State University of New Jersey, Piscataway, New Jersey, USA dunnmg@rwjms.rutgers.edu.
authors: Michael G
authors: MG
authors: Dunn
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D008422:Materials Testing; D008592:Menisci, Tibial / Q000601:surgery*; D023421:Models, Animal; D011108:Polymers; D012756:Sheep; D054457:Tissue Scaffolds
chemical_list: D011108:Polymers
keywords: biomechanics; knee; meniscus; tissue engineering