Degenerative Lesions in the Articular Cartilage after Meniscectomy

Berjon, J. Javier; Munuera, L.; Calvo, Miguel A.

doi:10.1097/00005373-199103000-00006

Cited by 36 publications

(30 citation statements)

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“…As a matter of fact, meniscectomy often determines dramatic changes in the knee biomechanics, often leading to the development of early osteoarthritis [6,10,11,13,21,24,Fig. 2 Macroscopic sections of the samples immediately after retrieval.…”

Section: Discussionmentioning

confidence: 99%

Healing of meniscal tissue by cellular fibrin glue: an in vivo study

Scotti

Pozzi

Mangiavini

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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Menisci represent fundamental structures for the maintenance of knee homeostasis, playing a key role in knee biomechanics. However, their intrinsic regenerative potential is poor. As a consequence, when a lesion occurs and the meniscus is partially removed by surgery, knee mechanics is subject to dramatic changes. These have been demonstrated to lead often to the development of early osteoarthritis. Therefore, menisci should be repaired whenever possible. In the last decades, tissue engineering approaches have been advocated to improve the reparative processes of joint tissues. In this study, the bonding capacity of an articular chondrocytes-fibrin glue hydrogel was tested as a biologic glue to improve the bonding between two swine meniscal slices in a nude mouse model. The composites were wrapped with acellular fibrin glue and implanted in subcutaneous pouches of nude mice for 4 weeks. Upon retrieval, a firm gross bonding was observed in the experimental samples while none of the control samples, prepared with acellular fibrin glue at the interface, presented any sign of bonding. This was consistent with the histological and scanning electron microscope findings. In particular, a fibrocartilaginous tissue was found at the interface between the meniscal slices, partially penetrating the native meniscus tissue. In order to overcome the lack of regenerative properties of the meniscus, the rationale of using cellular fibrin glue is that fibrin provides immediate stability while carrying cells in the site of lesion. Moreover, fibrin gel is recognized as an optimal scaffold for cell embedding and for promoting fibrocartilaginous differentiation of the cells which synthesize matrix having healing property. These results demonstrated the potential of this model for improving the meniscal bonding. However, further orthotopic studies in a large animal model are needed to evaluate its potential for clinical application.

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Section: Discussionmentioning

confidence: 99%

Healing of meniscal tissue by cellular fibrin glue: an in vivo study

Scotti

Pozzi

Mangiavini

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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“…These changes are similar to those seen in human osteoarthritis and include fibrillation and erosion of the articular cartilage, osteophyte formation, and subchondral bone remodeling [I ,3,9,12,22-241. One of the earliest detectable changes following meniscectomy is fibrillation of the articular cartilage of the medial tibial plateau, typically in the central region normally not covered by meniscus [3]. We previously have reported, using a within-subjects repeated measures design, that certain synovial lavage fluid biomarkers are significantly elevated following complete medial meniscectomy in dogs, with peak levels occurring 4 weeks after surgery [16].…”

Section: Introductionmentioning

confidence: 99%

Synovial fluid biomarker levels predict articular cartilage damage following complete medial meniscectomy in the canine knee

Carlson

Guilak

Vail

et al. 2002

Journal Orthopaedic Research

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The purposes of this study were to document the histological changes present in the tibial plateaus 12 weeks after complete medial meniscectomy in dogs and to determine if synovial lavage fluid biomarker levels are predictive of the severity ofjoint damage. Twelve adult dogs underwent complete unilateral medial meniscectomy and synovial lavage fluid biomarker levels, including cartilage oligomeric matrix protein (COMP), keratan sulfate (5D4), 3B3(-), and 3B3(+), were measured serially at 4-week intervals. The dogs were euthanized 12 weeks after surgery and each medial and lateral tibial plateau from the meniscectomized and contralateral knees was graded histologically. Histological data were analyzed using principal components analysis, which resulted in 4 factors that explained 70% of the variation in the data. Factor 2 (weighted most heavily by subchondral bone thickness) and Factor 3 (representative o f articular cartilage damage) were significantly affected by compartmental site (P < 0.01 for both). Both of these factors were highest in the medial tibial plateau of the meniscectomized knee, and Factor 3 was significantly higher in this site than in the medial tibial plateau of the contralateral knee ( P < 0.01). Peak levels of all 4 synovial lavage fluid biomarkers occurred at 4 weeks post-meniscectomy and 4-week minus baseline levels of all biomarkers were significantly correlated with the Factor 3 scores. This study demonstrates that significant articular cartilage damage occurs relatively quickly following complete medial meniscectomy in dogs and establishes the content and criterion validity for these synovial fluid lavage biomarkers in canine meniscectomy as surrogate measures of articular cartilage damage.

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“…Fresh tears of the menisci can be handled by conservative methods or primary open repair but the majority are treated by meniscectomy which has resulted in development of early osteoarthrifts with few exceptions [1,3,16]. Fresh tears of the menisci can be handled by conservative methods or primary open repair but the majority are treated by meniscectomy which has resulted in development of early osteoarthrifts with few exceptions [1,3,16].…”

Section: Introductionmentioning

confidence: 99%

In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy

Ihn

Kim

Park

1993

International Orthopaedics

160

102

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Many investigators have attempted to find the cause of the osteoarthritic changes after meniscectomy. Alteration of the mechanical factors resulting in stress concentration, is now thought to be one of the most important causes but few experimental studies have reported the differences in contact area and pressure distribution after partial or total meniscectomy. By using pressure sensitive film, we have calculated the contact area and the pattern of weight distribution in three different situations; intact meniscus, partial and total meniscectomy. The experimental materials were obtained from 5 above knee amputation specimens. The knee joint was fixed in full extension to an Instron machine using an aluminium box and mounting resin. Load was transmitted to the tibiofemoral joint containing the special film, within a physiological range. Analysis of the contact area for each situation (intact meniscus, partial and total meniscectomy) was made by reviewing the film. By measuring the contact area after meniscectomy, we showed that the meniscus performs a load transmitting function in the knee joint. The medial contact area of the tibiofemoral joint with an intact meniscus is always larger than the lateral compartment (1.36:1), but in partial and total meniscectomy the difference between them gradually decreased. There was a minor decrease in contact area after partial meniscectomy and a much greater decrease after total meniscectomy. The degree of stress concentration in the contact area was increased when part or all the meniscus was excised. There was little change of contact area in the opposite, intact side of the joint after partial meniscectomy, but marked change after total meniscectomy.

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Degenerative Lesions in the Articular Cartilage after Meniscectomy

Cited by 36 publications

References 0 publications

Healing of meniscal tissue by cellular fibrin glue: an in vivo study

Healing of meniscal tissue by cellular fibrin glue: an in vivo study

Synovial fluid biomarker levels predict articular cartilage damage following complete medial meniscectomy in the canine knee

In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy

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