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Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model.

Vrancken AC, Madej W, Hannink G, Verdonschot N, van Tienen TG, Buma P - PLoS ONE (2015)

Bottom Line: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed.This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading.Evidently, redesigning the fixation method is necessary.

View Article: PubMed Central - PubMed

Affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Orthopaedic Research Lab, Nijmegen, The Netherlands.

ABSTRACT

Purpose: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on the implant location in the joint, geometrical integrity of the implant and the effect of the implant on synovial membrane and articular cartilage histopathological condition.

Methods: The right medial meniscus of seven Saanen goats was replaced by the implant. Sham surgery (transection of the MCL, arthrotomy and MCL suturing) was performed in six animals. The contralateral knee joints of both groups served as control groups. After three months follow-up the following aspects of implant performance were evaluated: implant position, implant deformation and the histopathological condition of the synovium and cartilage.

Results: Implant geometry was well maintained during the three month implantation period. No signs of PCU wear were found and the implant did not induce an inflammatory response in the knee joint. In all animals, implant fixation was compromised due to suture breakage, wear or elongation, likely causing the increase in extrusion observed in the implant group. Both the femoral cartilage and tibial cartilage in direct contact with the implant showed increased damage compared to the sham and sham-control groups.

Conclusion: This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading. Failure of the fixation sutures may have increased implant mobility, which probably induced implant extrusion and potentially stimulated cartilage degeneration. Evidently, redesigning the fixation method is necessary. Future animal studies should evaluate the improved fixation method and compare implant performance to current treatment standards, such as allografts.

No MeSH data available.


Related in: MedlinePlus

Representative example of implant deformation.a) Top view. b) Side view). The light grey color is the reference prosthesis, the dark color the explanted prosthesis.
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pone.0133138.g009: Representative example of implant deformation.a) Top view. b) Side view). The light grey color is the reference prosthesis, the dark color the explanted prosthesis.

Mentions: Gross implant geometry was maintained during the three month follow-up period. Inspection of the microCT scans showed that the fixation sutures did not damage the implant bulk material. In the transverse plane, implant deformation was characterized by slight lengthening along the anteroposterior axis (Fig 9a and 9b, Table 1). Deformation of the anterior horn and mid body was minimal, while the posterior horn cross-sectional area decreased with 12.33% (Table 1).


Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model.

Vrancken AC, Madej W, Hannink G, Verdonschot N, van Tienen TG, Buma P - PLoS ONE (2015)

Representative example of implant deformation.a) Top view. b) Side view). The light grey color is the reference prosthesis, the dark color the explanted prosthesis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507942&req=5

pone.0133138.g009: Representative example of implant deformation.a) Top view. b) Side view). The light grey color is the reference prosthesis, the dark color the explanted prosthesis.
Mentions: Gross implant geometry was maintained during the three month follow-up period. Inspection of the microCT scans showed that the fixation sutures did not damage the implant bulk material. In the transverse plane, implant deformation was characterized by slight lengthening along the anteroposterior axis (Fig 9a and 9b, Table 1). Deformation of the anterior horn and mid body was minimal, while the posterior horn cross-sectional area decreased with 12.33% (Table 1).

Bottom Line: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed.This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading.Evidently, redesigning the fixation method is necessary.

View Article: PubMed Central - PubMed

Affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Orthopaedic Research Lab, Nijmegen, The Netherlands.

ABSTRACT

Purpose: Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on the implant location in the joint, geometrical integrity of the implant and the effect of the implant on synovial membrane and articular cartilage histopathological condition.

Methods: The right medial meniscus of seven Saanen goats was replaced by the implant. Sham surgery (transection of the MCL, arthrotomy and MCL suturing) was performed in six animals. The contralateral knee joints of both groups served as control groups. After three months follow-up the following aspects of implant performance were evaluated: implant position, implant deformation and the histopathological condition of the synovium and cartilage.

Results: Implant geometry was well maintained during the three month implantation period. No signs of PCU wear were found and the implant did not induce an inflammatory response in the knee joint. In all animals, implant fixation was compromised due to suture breakage, wear or elongation, likely causing the increase in extrusion observed in the implant group. Both the femoral cartilage and tibial cartilage in direct contact with the implant showed increased damage compared to the sham and sham-control groups.

Conclusion: This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading. Failure of the fixation sutures may have increased implant mobility, which probably induced implant extrusion and potentially stimulated cartilage degeneration. Evidently, redesigning the fixation method is necessary. Future animal studies should evaluate the improved fixation method and compare implant performance to current treatment standards, such as allografts.

No MeSH data available.


Related in: MedlinePlus