Meniscal replacement in dogs. Tissue regeneration in two different materials with similar properties

Tienen, T.G. van; Heijkants, R. G. J. C.; Groot, J.H. de; Schouten, A.J.; Pennings, A. J.; Veth, R.P.H.; Buma, P.

doi:10.1002/jbm.b.30406

Cited by 81 publications

(71 citation statements)

References 50 publications

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“…40,41 This was again observed in the present study. We speculated that the improved surface properties of the implant would have a beneficial effect on chondroprotection, but that was not found in this study.…”

Section: Discussionsupporting

confidence: 91%

“…Similar to previous studies, a remodeling into a cartilage-like tissue with type II and GAGs was found in the inner higher loaded region of the scaffold. 40,41 However, the amount of differentiation after 6 months in this study was less than in previous studies with the same polymer. 40,41 Tissue differentiation from fibrovascular to cartilage-like had progressed in the 24-month implants, particularly in the central region of each scaffold.…”

Section: Discussioncontrasting

confidence: 83%

“…40,41 However, the amount of differentiation after 6 months in this study was less than in previous studies with the same polymer. 40,41 Tissue differentiation from fibrovascular to cartilage-like had progressed in the 24-month implants, particularly in the central region of each scaffold. In the peripheral transitional zone to the synovial tissue, collagen type II staining was absent, similar as the distribution in the native meniscus.…”

Section: Discussioncontrasting

confidence: 83%

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Effect on Tissue Differentiation and Articular Cartilage Degradation of a Polymer Meniscus Implant

et al. 2008

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Background Replacement of the meniscus by an implant could potentially avoid cartilage degeneration. Hypothesis An implant of degradable polycaprolacton-polyurethane should act as a temporary scaffold enabling regeneration of a new meniscus by slow degradation of the polymer and simultaneous in-growth and differentiation of tissues into the typical cartilage-like tissue of the meniscus. Study Design Controlled laboratory study. Methods In 13 dogs’ knees, the lateral meniscus was replaced with a porous polymer implant (6 and 7 for 6- and 24-month follow-up, respectively); in 7 knees only a meniscectomy was performed. In 6 knees, no surgery was performed. After 6 and 24 months, the implants and the articular cartilage were histologically evaluated. Compression-stress tests were performed on implant biopsy specimens. Results The implants were fully integrated into the tissue without formation of a capsule. The foreign body reaction did not exceed grade I. Differentiation from fibrous- to cartilage-like tissue was pronounced after 24 months. Viable cells were particularly absent after 24 months in central parts of the most anterior part of the scaffold. The mechanical properties of the implants were intermediate between the scaffold before implantation and native meniscus tissue and were not different between 6 and 24 months. After both 6 and 24 months, small areas of the implant were not covered with tissue. Cartilage degeneration was not prevented. Conclusion A final remodeling of tissue into neomeniscus tissue could not take place since the original structure of the polymer was still present after 24 months. The implant did not prevent cartilage degradation. Several factors are discussed that may be responsible for this. Clinical Relevance Although clinical application of a polymer implant for the replacement of the entire meniscus is not supported by this study, the authors strongly believe in the concept, but further improvements in the implant and surgical technique are needed before such an implant can be recommended for human clinical use.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 83%

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Effect on Tissue Differentiation and Articular Cartilage Degradation of a Polymer Meniscus Implant

et al. 2008

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“…Tienen et al proffered that if inflammatory cells are unable to penetrate small pores then giant cells will accumulate and attempt to phagocytose the material 37 .…”

Section: Discussionmentioning

confidence: 99%

Structural variants of biodegradable polyesterurethane in vivo evoke a cellular and angiogenic response that is dictated by architecture

et al. 2009

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The aim of this study was to investigate an in-vivo tissue response to a biodegradable polyesterurethane, specifically the cellular and angiogenic response evoked by varying implant architectures in a subcutaneous rabbit implant model. A synthetic biodegradable polyesterurethane was synthesised and processed into three different configurations; a non-porous film, a porous mesh and a porous membrane. Glutaraldehyde cross-linked bovine pericardium was used as a control. Sterile polyesterurethane and control samples were implanted subcutaneously in six rabbits, (n=12). The rabbits were sacrificed at 21 and 63 days and the implant sites were sectioned and histologically stained using haemotoxylin and eosin (H&E), Masson's trichrome, picosirius red and immunostain CD31. The tissue-implant interface thickness was measured from the H&E slides.Stereological techniques were used to quantify the tissue reaction at each time point that included volume fraction of inflammatory cells, fibroblasts, fibrocytes, collagen and the degree of vascularisation. Stereological analysis inferred that porous scaffolds with regular topography are better tolerated in-vivo compared to non-porous scaffolds, while increasing scaffold porosity promotes angiogenesis and cellular infiltration. The results suggest that this biodegradable polyesterurethane is better tolerated in-vivo than the control and that structural variants of biodegradable polyesterurethane in-vivo evoke a cellular and angiogenic response that is dictated by architecture.

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“…A polyvinyl alcohol-hydrogel meniscus in rabbits showed promising results in terms of chondroprotection, but certain unresolved problems persisted, such as durability of the polymer, the fixation method, and complete tissue regeneration in a material that does not adhere to tissue. 18,19 Tienen et al 20 applied two different porous polyester urethane polymers as meniscus prostheses in dogs. Although they also showed promising results in respect of tissue formation, one of the materials (aromatic 4,4,-diphenylmethanediisocynate based) is thought to degrade into toxic products.…”

Section: Introduction Lmentioning

confidence: 99%

Tissue Engineering for Total Meniscal Substitution: Animal Study in Sheep Model

Kon

Chiari

Marcacci

et al. 2008

Tissue Engineering Part A

111

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Objective: The aim of the study was to investigate the use of a novel hyaluronic acid/polycaprolactone material for meniscal tissue engineering and to evaluate the tissue regeneration after the augmentation of the implant with expanded autologous chondrocytes. Two different surgical implantation techniques in a sheep model were evaluated. Methods: Twenty-four skeletally mature sheep were treated with total medial meniscus replacements, while two meniscectomies served as empty controls. The animals were divided into two groups: cell-free scaffold and scaffold seeded with autologous chondrocytes. Two different surgical techniques were compared: in 12 animals, the implant was sutured to the capsule and to the meniscal ligament; in the other 12 animals, also a transtibial fixation of the horns was used. The animals were euthanized after 4 months. The specimens were assessed by gross inspection and histology.

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Meniscal replacement in dogs. Tissue regeneration in two different materials with similar properties

Cited by 81 publications

References 50 publications

Effect on Tissue Differentiation and Articular Cartilage Degradation of a Polymer Meniscus Implant

Effect on Tissue Differentiation and Articular Cartilage Degradation of a Polymer Meniscus Implant

Structural variants of biodegradable polyesterurethane in vivo evoke a cellular and angiogenic response that is dictated by architecture

Tissue Engineering for Total Meniscal Substitution: Animal Study in Sheep Model

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