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meniscus implant

Bahar Bilgen, Chathuraka T Jayasuriya, Brett D Owens
The meniscus is the most commonly injured structure in the human knee. Meniscus deficiency has been shown to lead to advanced osteoarthritis (OA) due to abnormal mechanical forces, and replacement strategies for this structure have lagged behind other tissue engineering endeavors. The challenges include the complex 3D structure with individualized size parameters, the significant compressive, tensile and shear loads encountered, and the poor blood supply. In this progress report, a review of the current clinical treatments for different types of meniscal injury is provided...
March 15, 2018: Advanced Healthcare Materials
Jakob M Townsend, Brian T Andrews, Yi Feng, Jinxi Wang, Randolph J Nudo, Erik Van Kampen, Stevin H Gehrke, Cory J Berkland, Michael S Detamore
Traumatic brain injury (TBI) is a life-threatening condition defined by internal brain herniation. Severe TBI is commonly treated by a two-stage surgical intervention, where decompressive craniectomy is first conducted to remove a large portion of calvarial bone and allow unimpeded brain swelling. In the second surgery, spaced weeks to months after the first, cranioplasty is performed to restore the cranial bone. Hydrogels with paste-like precursor solutions for surgical placement may potentially revolutionize TBI treatment by permitting a single-stage surgical intervention, capable of being implanted with the initial surgery, remaining pliable during brain swelling, and tuned to regenerate calvarial bone after brain swelling has subsided...
February 26, 2018: Acta Biomaterialia
Joan C Monllau, Francesco Poggioli, Juan Erquicia, Eduardo Ramírez, Xavier Pelfort, Pablo Gelber, Raúl Torres-Claramunt
PURPOSE: To report the magnetic resonance imaging (MRI) and clinical outcomes at a minimum 5-year follow-up in a series of patients with postmeniscectomy syndrome and treated with a polyurethane scaffold. METHODS: All consecutive patients operated on from September 2008 to February 2011 for either persistent medial or lateral joint line compartmental pain receiving a polyurethane scaffold due to a previous partial meniscus resection with a minimum 5-year follow-up were included...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Christian Stärke, Christoph Hubertus Lohmann, Sebastian Kopf
Development of meniscus replacements requires in-depth knowledge of the material properties and biomechanical behavior of the native meniscus. The compressive properties are of particular interest in this context, which are often assessed with indentation tests. However, those tests are usually done on isolated tissue specimens ex situ, which could have a significant impact on the results. It was, therefore, the goal of the study to assess the stiffness of the meniscus tissue in situ in porcine specimens and to compare it to that of artificial substitutes...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Mamatha M Pillai, J Gopinathan, R Senthil Kumar, G Sathish Kumar, S Shanthakumari, K Santosh Sahanand, Amitava Bhattacharyya, R Selvakumar
Tissue engineered constructs with rapid restoration of mechanical and biological properties remains a challenge, emphasizing the need to develop novel scaffolds. Here we present a multi-component composite 3D scaffold structure with biomimetic reinforcement and biomolecule functionalization for meniscus tissue engineering. The scaffold structure was developed using 3:1 silk fibroin (SF) and polyvinyl alcohol (PVA). Autoclaved eggshell membrane (AESM) powder (1-3%w/v) was used as reinforcement to enhance biomechanical properties...
February 20, 2018: Journal of Biomedical Materials Research. Part A
Hiroshi Nakayama, Ryo Kanto, Shunichiro Kambara, Kenji Kurosaka, Shintaro Onishi, Shinichi Yoshiya, Motoi Yamaguchi
Objective: To examine the clinical and functional outcomes for a series of patients who underwent meniscal repair for isolated meniscal tears focusing the study population on athletes. Methods: This study represents a case series of 46 athletes who underwent repair of isolated meniscal lesions of the knee from 2010 to 2015. Cases of discoid meniscal lesions and combined ligament injuries were excluded. The mean age of the patients was 22.9 years ranging from 12 to 50 years...
October 2017: Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology
Darby A Houck, Matthew J Kraeutler, John W Belk, Eric C McCarty, Jonathan T Bravman
PURPOSE: The purpose of this systematic review is to evaluate the current literature in an effort to assess specific clinical outcomes following meniscal scaffold implantation using the two available scaffolds: Collagen Meniscal Implant (CMI) and the Actifit polyurethane meniscal scaffold. METHODS: A systematic review was performed by searching PubMed, Embase, and Cochrane Library to find studies evaluating clinical outcomes of patients undergoing meniscal scaffold implantation...
January 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Leonardo Mastropasqua, Mario Nubile, Niccolò Salgari, Rodolfo Mastropasqua
PURPOSE: To investigate the in vivo effect of a novel femtosecond laser-assisted procedure termed stromal lenticule addition keratoplasty for advanced keratoconus. METHODS: Ten patients with stage III and IV stable keratoconus were included. Negative meniscus-shaped stromal lenticules were produced from corneoscleral eye bank buttons with a refractive lenticule extraction procedure with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Recipient corneas underwent a modified femtosecond laser flap-cut procedure to produce an intrastromal pocket and lenticules were implanted...
January 1, 2018: Journal of Refractive Surgery
K-T Kang, J Son, D-S Suh, S K Kwon, O-R Kwon, Y-G Koh
OBJECTIVES: Patient-specific (PS) implantation surgical technology has been introduced in recent years and a gradual increase in the associated number of surgical cases has been observed. PS technology uses a patient's own geometry in designing a medical device to provide minimal bone resection with improvement in the prosthetic bone coverage. However, whether PS unicompartmental knee arthroplasty (UKA) provides a better biomechanical effect than standard off-the-shelf prostheses for UKA has not yet been determined, and still remains controversial in both biomechanical and clinical fields...
January 2018: Bone & Joint Research
G M Peretti, I Tessaro, L Montanari, U Polito, A Di Giancamillo, M Di Giancamillo, A Marmotti, A Montaruli, E Roveda, L Mangiavini
In the last few years, different tissue engineering strategies have been developed for the repair of osteochondral lesions. When the osteochondral scaffold is implanted on the femoral condyle, the meniscus might be affected by the implant and might undergo a progressive degeneration. The aim of our study is to analyze the morphological changes of the meniscus following an osteochondral lesion and the implant of a biphasic scaffold. A critical osteochondral defect was generated in the medial femoral condyle of mature sheep...
October 2017: Journal of Biological Regulators and Homeostatic Agents
Susanne M Eijgenraam, Max Reijman, Sita M A Bierma-Zeinstra, Daan T van Yperen, Duncan E Meuffels
NHS-PROSPERO REGISTRATION NUMBER: 42016048592 OBJECTIVE: In order to make a more evidence-based selection of patients who would benefit the most from arthroscopic partial meniscectomy (APM), knowledge of prognostic factors is essential. We conducted a systematic review of predictors for the clinical outcome following APM. DESIGN: Systematic review DATA SOURCES: Medline, Embase, Cochrane Central Register, Web of Science, SPORTDiscus, PubMed Publisher, Google Scholar INCLUSION CRITERIA: Report an association between factor(s) and clinical outcome; validated questionnaire; follow-up >1 year...
November 28, 2017: British Journal of Sports Medicine
Srujana Vedicherla, Sara Romanazzo, Daniel J Kelly, Conor T Buckley, Cathal J Moran
Purpose/aim of study: Menisectomies account for over 1.5 million surgical interventions in Europe annually, and there is a growing interest in regenerative strategies to improve outcomes in meniscal replacement. The overall objective of this study was to evaluate the role of intraoperatively applied fresh chondrocyte (FC) isolates compared to minced cartilage (MC) fragments, used without cell isolation, to improve bioactivity and tissue integration when combined with a polyurethane replacement. MATERIALS AND METHODS: First, to optimize the intraoperative cell isolation protocol, caprine articular cartilage biopsies were digested with 750 U/ml or 3000 U/ml collagenase type II (ratio of 10 ml per g of tissue) for 30 min, 1 h or 12 h with constant agitation and compared to culture-expanded chondrocytes in terms of matrix deposition when cultured on polyurethane scaffolds...
November 28, 2017: Connective Tissue Research
Gabrielle Deprés-Tremblay, Anik Chevrier, Nicolas Tran-Khanh, Monica Nelea, Michael D Buschmann
Platelet-rich plasma (PRP) has been used to treat different orthopedic conditions, however, the clinical benefits of using PRP remain uncertain. Chitosan (CS)-PRP implants have been shown to improve meniscus, rotator cuff and cartilage repair in pre-clinical models. The purpose of this current study was to investigate in vitro and in vivo mechanisms of action of CS-PRP implants. Freeze-dried formulations containing 1% (w/v) CS (80% degree of deacetylation and number average molar mass 38 kDa), 1% (w/v) trehalose as a lyoprotectant and 42...
November 10, 2017: Biomedical Materials
Bryan M Saltzman, Maximilian A Meyer, Timothy S Leroux, Matthew E Gilelis, Margot Debot, Adam B Yanke, Brian J Cole
PURPOSE: To compare a series of patients who underwent meniscus allograft transplantation (MAT) with full-thickness chondral defects (FTD) with those with no chondral defect (ND) with regard to the following: change in patient-reported outcomes (PROs) from baseline to 2-year follow-up and baseline to the final follow-up (including comparisons to minimal clinically important differences), complications and complication rates, reoperations and reoperation rates/timing, and failures and time to failure (revision MAT or conversion to total knee arthroplasty)...
November 2, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Johannes Zellner, Girish Pattappa, Matthias Koch, Siegmund Lang, Johannes Weber, Christian G Pfeifer, Michael B Mueller, Richard Kujat, Michael Nerlich, Peter Angele
BACKGROUND: Treatment of meniscus tears within the avascular region represents a significant challenge, particularly in a situation of early osteoarthritis. Cell-based tissue engineering approaches have shown promising results. However, studies have not found a consensus on the appropriate autologous cell source in a clinical situation, specifically in a challenging degenerative environment. The present study sought to evaluate the appropriate cell source for autologous meniscal repair in a demanding setting of early osteoarthritis...
October 10, 2017: Stem Cell Research & Therapy
Geert Peersman, Josh Slane, Philippe Vuylsteke, Susanne Fuchs-Winkelmann, Philipp Dworschak, Thomas Heyse, Lennart Scheys
INTRODUCTION: Fixed-bearing unicompartmental knee arthroplasty (UKA) closely replicates native knee kinematics. As few studies have assessed kinematics following mobile-bearing (MB) UKA, the current study aimed to investigate whether MB UKA preserves natural knee kinematics. MATERIALS AND METHODS: Seven fresh-frozen full-leg cadaver specimens were prepared and mounted in a kinematic rig that allowed all degrees of freedom at the knee. Three motion patterns, passive flexion-extension (0°-110° flexion), open-chain extension (5°-70° flexion) and squatting (30°-100° flexion), were performed pre- and post-implantation of a medial MB UKA and compared in terms of rotational and translational knee joint kinematics in the different anatomical planes, respectively...
September 21, 2017: Archives of Orthopaedic and Trauma Surgery
C Stärke, S Kopf, R Becker
BACKGROUND: Meniscal lesions are among the most important musculoskeletal disorders and are the most common indication for knee joint arthroplasty. However, the structural integrity and function is rarely retained, and a loss of tissue results. Thus, there is a huge demand for meniscal replacement options. CURRENT PROCEDURES: Autografts were used in the past but did not fulfill expectations. Meniscus allografts have been developed to be a viable treatment option...
October 2017: Der Orthopäde
He Huang, Hongyao Xu, Jianning Zhao
BACKGROUND: The meniscus is one of the most commonly injured parts of the body, and meniscal healing is difficult. HYPOTHESIS: Kartogenin (KGN) induces tendon stem cells (TSCs) to differentiate into cartilage cells in vitro and form meniscus-like tissue in vivo. A damaged meniscus can be replaced with a KGN-treated autologous tendon graft. STUDY DESIGN: Controlled laboratory study. METHODS: In the in vitro experiments, TSCs were isolated from rabbit patellar tendons and cultured with various concentrations of KGN, from 0 to 1000 µM...
December 2017: American Journal of Sports Medicine
Andrzej Brzezinski, Salim A Ghodbane, Jay M Patel, Barbara A Perry, Charles J Gatt, Michael G Dunn
Meniscus injuries represent one of the most-common intra-articular knee injuries. The current treatment options include meniscectomy and allograft transplantation, both with poor long-term outcomes. Therefore, there is a need for regenerative techniques to restore meniscal function. To preclinically test scaffolds for meniscus replacement, large animal models need to be established and standardized. This review establishes the anatomical and compositional similarities between human and sheep menisci and provides guidance for implantation and evaluation of such devices...
December 2017: Tissue Engineering. Part C, Methods
Jie Sun, Sanjairaj Vijayavenkataraman, Hang Liu
Current surgical treatments for meniscal tears suffer from subsequent degeneration of knee joints, limited donor organs and inconsistent post-treatment results. Three clinical scaffolds (Menaflex CMI, Actifit(®) scaffold and NUsurface(®) Meniscus Implant) are available on the market, but additional data are needed to properly evaluate their safety and effectiveness. Thus, many scaffold-based research activities have been done to develop new materials, structures and fabrication technologies to mimic native meniscus for cell attachment and subsequent tissue development, and restore functionalities of injured meniscus for long-term effects...
January 3, 2017: Materials
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