Successful Total Meniscus Reconstruction Using a Novel Fiber-Reinforced Scaffold

Merriam, Aaron R.; Patel, Jay M.; Culp, Brian M.; Gatt, Charles J.; Dunn, Michael G.

doi:10.1177/0363546515595065

Cited by 50 publications

(59 citation statements)

References 43 publications

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“…Sodium hyaluronate (0.25 g/L; molecular weight 1.5–2.2 MDa, Acros Organic, Bridgewater, NJ) was dissolved in dilute hydrochloric acid (pH 2.35). Lyophilized bovine Achilles tendon collagen (Worthington Biochemical Corporation, Lakewood, NJ) was ground and swollen in the acidic solution (20 g/L), adapted from previous methods . The scaffolds were infused with COL‐HA, frozen, and lyophilized.…”

Section: Methodsmentioning

confidence: 99%

“…A resorbable total meniscus replacement scaffold composed of a woven poly(desaminotyrosyl‐tyrosine dodecyl ester dodecanoate) [poly(DTD DD)] fiber reinforced collagen‐hyaluronan (COL‐HA) sponge was previously developed . The scaffold was designed to match the circumferential tensile and axial compressive mechanics of the native ovine meniscus with appropriate porosity (>70%) for tissue infiltration.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical characterization of a novel collagen‐hyaluronan infused 3D‐printed polymeric device for partial meniscus replacement

et al. 2019

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The menisci transmit load by increasing the contact area and decreasing peak contact stresses on the articular surfaces. Meniscal lesions are among the most common orthopedic injuries, and resulting meniscectomies are associated with adverse polycaprolactone contact mechanics changes and, ultimately, an increased likelihood of osteoarthritis. Meniscus scaffolds were fabricated by 3D‐printing a network of circumferential and radial filaments of resorbable polymer (poly(desaminotyrosyl‐tyrosine dodecyl ester dodecanoate)) and infused with collagen‐hyaluronan. The scaffold demonstrated an instantaneous compressive modulus (1.66 ± 0.44 MPa) comparable to native meniscus (1.52 ± 0.59 MPa). The scaffold aggregate modulus (1.33 ± 0.51 MPa) was within 2% of the native value (1.31 ± 0.36 MPa). In tension, the scaffold displayed a comparable stiffness to native tissue (127.6–97.1 N/mm) and an ultimate load of 33% of the native value. Suture pull‐out load of scaffolds (83.1 ± 10.0 N) was within 10% of native values (91.5 ± 15.4 N). Contact stress analysis demonstrated the scaffold reduced peak contact stress by 60–67% and increased contact area by 38%, relative to partial meniscectomy. This is the first meniscal scaffold to match both the axial compressive properties and the circumferential tensile stiffness of the native meniscus. The improvement of joint contact mechanics, relative to partial meniscectomy alone, motivates further investigation using a large animal model. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2457–2465, 2019.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical characterization of a novel collagen‐hyaluronan infused 3D‐printed polymeric device for partial meniscus replacement

et al. 2019

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“…The collagen scaffold preparation protocol was adapted from our previous study . Isolated collagen was ground into a powder with particle size <425 μm.…”

Section: Methodsmentioning

confidence: 99%

“…However, to our knowledge a direct comparative study on the properties of bovine, porcine, and ovine tendon‐derived collagenous scaffolds is lacking. The goal of this study was to assess porcine and ovine derived scaffolds as potential replacements of bovine scaffolds fabricated using a previously developed lyophilization procedure . We hypothesize that EDC cross‐linked collagenous sponge‐like scaffolds isolated from porcine and ovine tendons possess comparable mechanical and physical properties as those derived from bovine tendons.…”

Section: Introductionmentioning

confidence: 99%

Physical and mechanical properties of cross‐linked type I collagen scaffolds derived from bovine, porcine, and ovine tendons

Ghodbane

Dunn

2016

J Biomedical Materials Res

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Collagen scaffolds are often utilized in tissue engineering applications where their performance depends on physical and mechanical properties. This study investigated the effects of collagen source (bovine, porcine, and ovine tendon) on properties of collagen sponge scaffolds cross-linked with 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS). Scaffolds were tested for tensile and compressive properties, stability (resistance to enzymatic degradation), pore size, and swelling ratio. No significant differences in tensile modulus were observed, but ovine scaffolds had significantly greater ultimate strain, stress, and toughness relative to bovine and porcine scaffolds. No significant differences in compressive properties, pore size, or swelling ratio were observed as a function of collagen source. Ovine scaffolds were more resistant to collagenase degradation compared to bovine samples, which were more resistant than porcine scaffolds. In comparison to bovine scaffolds, ovine scaffolds performed equivalently or superiorly in all evaluations, and porcine scaffolds were equivalent in all properties except enzymatic stability. These results suggest that collagen sponges derived from bovine, porcine, and ovine tendon have similar physical and mechanical properties, and are all potentially suitable materials for various tissue engineering applications.

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“…Meniscal injury results in approximately 850,000 surgical procedures annually in the United States and is the most common pathology of the knee joint, with an annual incidence of 66 per 100,000 people [8,9]. The surgical procedure most commonly performed to treat meniscus pathology is partial meniscectomy (excision of the damaged tissue).…”

Section: Introductionmentioning

confidence: 99%

Mechanical function near defects in an aligned nanofiber composite is preserved by inclusion of disorganized layers: Insight into meniscus structure and function

et al. 2017

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The meniscus is comprised of circumferentially aligned fibers that resist the tensile forces within the meniscus (i.e., hoop stress) that develop during loading of the knee. Although these circumferential fibers are severed by radial meniscal tears, tibial contact stresses do not increase until the tear reaches ~90% of the meniscus width, suggesting that the severed circumferential fibers still bear load and maintain the mechanical functionality of the meniscus. Recent data demonstrates that the interfibrillar matrix can transfer strain energy to disconnected fibrils in tendon fascicles. In the meniscus, interdigitating radial tie fibers, which function to stabilize and bind the circumferential fibers together, are hypothesized to function in a similar manner by transmitting load to severed circumferential fibers near a radial tear. To test this hypothesis, we developed an engineered fibrous analog of the knee meniscus using poly(ε-caprolactone) to create aligned scaffolds with variable amounts of non-aligned elements embedded within the scaffold. We show that the tensile properties of these scaffolds are a function of the ratio of aligned to non-aligned elements, and change in a predictable fashion following a simple mixture model. When measuring the loss of mechanical function in scaffolds with a radial tear, compared to intact scaffolds, the decrease in apparent linear modulus was reduced in scaffolds containing non-aligned layers compared to purely aligned scaffolds. Increased strains in areas adjacent to the defect were also noted in composite scaffolds. These findings indicate that non-aligned (disorganized) elements interspersed within an aligned network can improve overall mechanical function by promoting strain transfer to nearby disconnected fibers. This finding supports the notion that radial tie fibers may similarly promote tear tolerance in the knee meniscus, and will direct changes in clinical practice and provide guidance for tissue engineering strategies.

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Successful Total Meniscus Reconstruction Using a Novel Fiber-Reinforced Scaffold

Abstract: This meniscus replacement scaffold has the potential to improve surgical treatment and provide better long-term outcomes for those suffering from severe meniscus damage.

Cited by 50 publications

References 43 publications

Biomechanical characterization of a novel collagen‐hyaluronan infused 3D‐printed polymeric device for partial meniscus replacement

Biomechanical characterization of a novel collagen‐hyaluronan infused 3D‐printed polymeric device for partial meniscus replacement

Physical and mechanical properties of cross‐linked type I collagen scaffolds derived from bovine, porcine, and ovine tendons

Mechanical function near defects in an aligned nanofiber composite is preserved by inclusion of disorganized layers: Insight into meniscus structure and function

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