Skip to main content
SpringerLink
Log in

Alternatives to Meniscus Transplantation Outside the United States

  • Chapter
  • First Online:
Cartilage Restoration

  • 1268 Accesses

Abstract

Over the years, the surgical treatment of meniscal injury or damage has changed from total meniscectomy to partial meniscectomy or repair. The goal with arthroscopic methods is to preserve as much functional meniscal tissue as possible, rather than to remove it. During recent years, efforts have increasingly focused on the promotion of meniscal healing, as well as the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. This chapter will focus on three types of meniscal substitutes, their biological and biomechanical properties, and their clinical relevance. None are available for patient use in the USA at the time of this writing. These substitutes are: the biological MenaflexTM or collagen meniscal implant (CMI), the biomimetic ActifitTM meniscal scaffold, and the nonbiological NUsurface® meniscal substitute. In addition to the surgical techniques, clinical outcomes for the respective devices will be reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lee SJ, Aadalen KJ, Malaviya P, et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med. 2006;34(8):1334–44.

    Article  PubMed  Google Scholar 

  2. Jouve F, Ovadia H, Pujol N, Beaufils P. Meniscal repair: technique. In: Beaufils P, Verdonk R, Editors. The Meniscus. Heidelberg: Springer; 2010. S. 119–28.

    Google Scholar 

  3. Stärke C, Kopf S, Petersen W, et al. Meniscal repair. Arthroscopy. 2009;25:1033–44.

    Article  PubMed  Google Scholar 

  4. Jacobi M, Jakob RP. Meniscal repair: enhancement of healing process. In: Beaufils P, Verdonk R, Editors. The meniscus. Heidelberg: Springer; 2010. S. 129–35.

    Chapter  Google Scholar 

  5. Verdonk P. The future. In: Beaufils P, Verdonk R, Editors. The meniscus. Heidelberg: Springer; 2010. S. 399–400.

    Google Scholar 

  6. Schmidt MB, Chen EH, Lynch SE. A review of the effects of insulin-like growth factor and platelet derived growth factor on in vivo cartilage healing and repair. Osteoarthr Cartil. 2006;14:403–12.

    Article  PubMed  CAS  Google Scholar 

  7. Longo UG, Loppini M, Forriol F, et al. Advances in meniscal tissue engineering. Stem Cells Int. 2012;2012:1–11.

    Google Scholar 

  8. Verdonk PCM, Verstraete KL, Almqvist KF, et al. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthroscopy. 2006;14(8):694–706.

    Article  Google Scholar 

  9. Lewinski G von, Wirth CJ. Meniscal reconstruction—Allograft. Basic science. In: Beaufils P, Verdonk R, Editors. The meniscus. Heidelberg: Springer; 2010. S. 303–13.

    Chapter  Google Scholar 

  10. Stone KR, Rodkey WG, Webber R, et al. Meniscal regeneration with co polymeric collagen scaffolds. In vitro and in vivo studies evaluated clinically, histologically, and biochemically. Am J Sports Med. 1992;20(2):104–11.

    Article  PubMed  CAS  Google Scholar 

  11. de Groot J. Actifit, polyurethane meniscus implant: basic science. In: Beaufils P, Verdonk R, Editors. The meniscus. Heidelberg: Springer; 2010. S. 383–6.

    Google Scholar 

  12. iForma knee interpositional device. ConforMIS, Inc. http://www.atmedicals.com/PDFs/iForma_cirujano_catalogo.pdf. Accessed 8 Mar 2012.

  13. UniSpacer knee replacement: an alternative treatment for patients with arthritis. Zimmer, Inc. http://www.zimmer.com/z/ctl/op/global/action/1/id/9272/template/PC/navid/1879. Accessed 8 Mar 2012.

  14. Nusurface® meniscus implant. Active implants. http://www.activeimplants.com/our-products/nusurfacer-meniscus-implant.html. Accessed 8 Mar 2012.

  15. Rodkey WG, Steadman JR, Li ST. A clinical study of collagen meniscus implants to restore the injured meniscus. Clin Orthop Relat Res. 1999;367(Suppl):S281–92.

    Article  PubMed  Google Scholar 

  16. Stone KR, Steadman JR, Rodkey WG, et al. Regeneration of meniscal cartilage with use of a collagen scaffold. Analysis of preliminary data. J Bone Joint Surg Am. 1997;79(12):1770–7.

    PubMed  CAS  Google Scholar 

  17. Bulgheroni P, Murena L, Ratti C, et al. Follow-up of collagen meniscus implant patients: clinical, radiological, and magnetic resonance imaging results at 5 years. Knee. 2010;17(3):224–9.

    Article  PubMed  Google Scholar 

  18. Monllau JC, Gelber PE, Abat F, et al. Outcome after partial medial meniscus substitution with the collagen meniscal implant at a minimum of 10 years’ follow-up. Arthroscopy. 2011;27(7):933–43.

    Article  PubMed  Google Scholar 

  19. Rodkey WG, DeHaven KE, Montgomery WH, 3rd, et al. Comparison of the collagen meniscus implant with partial meniscectomy. A prospective randomized trial. J Bone Joint Surg Am. 2008;90(7):1413–26.

    Article  PubMed  Google Scholar 

  20. Zaffagnini S, Marcheggiani Muccioli GM, Lopomo N, et al. Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy: a minimum 10-year follow-up study. Am J Sports Med. 2011;39(5):977–85.

    Article  PubMed  Google Scholar 

  21. Harston A, Nyland J, Brand E, et al. Collagen meniscus implantation: a systematic review including rehabilitation and return to sports activity. Knee Surg Sports Traumatol Arthrosc. 2012;20(1):135–46.

    Article  PubMed  Google Scholar 

  22. Genovese E, Angeretti MG, Ronga M, et al. Follow-up of collagen meniscus implants by MRI. Radiol Med. 2007;112(7):1036–48.

    Article  PubMed  CAS  Google Scholar 

  23. Reguzzoni M, Manelli A, Ronga M, et al. Histology and ultrastructure of a tissue-engineered collagen meniscus before and after implantation. J Biomed Mater Res B Appl Biomater. 2005;74(2):808–16.

    PubMed  Google Scholar 

  24. Ronga M, Grassi FA, Manelli A, et al. Tissue engineering techniques for the treatment of a complex knee injury. Arthroscopy. 2006;22(5):576.e1–3.

    PubMed  Google Scholar 

  25. Steadman JR, Rodkey WG. Tissue-engineered collagen meniscus implants: 5- to 6-year feasibility study results. Arthroscopy. 2005;21(5):515–25.

    Article  PubMed  Google Scholar 

  26. Zaffagnini S, Giordano G, Vascellari A, et al. Arthroscopic collagen meniscus implant results at 6 to 8 years follow up. Knee Surg Sports Traumatol Arthrosc. 2007;15(2):175–83.

    Article  PubMed  Google Scholar 

  27. Verdonk R, Verdonk P, Huysse W, et al. Tissue ingrowth after implantation of a novel, biodegradable polyurethane scaffold for treatment of partial meniscal lesions. Am J Sports Med. 2011;39(4):774–82.

    Article  PubMed  Google Scholar 

  28. Minnen B van, Leeuwen MB van, Kors G, et al. In vivo resorption of a biodegradable polyurethane foam, based on 1,4-butanediisocyanate: a three-year subcutaneous implantation study. J Biomed Mater Res A. 2008;85(4):972–82.

    PubMed  Google Scholar 

  29. Zuidema J, Minnen B van, Span MM, et al. In vitro degradation of a biodegradable polyurethane foam, based on 1,4-butanediisocyanate: a three-year study at physiological and elevated temperature. J Biomed Mater Res A. 2009;90(3):920–30.

    PubMed  CAS  Google Scholar 

  30. Tienen TG, Heijkants RG, Groot JH de, et al. Replacement of the knee meniscus by a porous polymer implant: a study in dogs. Am J Sports Med. 2006;34(1):64–71.

    Article  PubMed  Google Scholar 

  31. Verdonk R, Verdonk P, Heinrichs EL. Polyurethane meniscus implant: technique. In: Beaufils P, Verdonk R, Editors. The meniscus. Heidelberg: Springer; 2010. S.  389–4.

    Chapter  Google Scholar 

  32. ActifitTM rehabilitation programme. ORTEQ. http://ortEq.com/healthcare/rehabilitation. Accessed 8 Mar 2012.

  33. Verdonk P, Beaufils P, Bellemans J, et al. Successful treatment of painful irreparable partial meniscal defects with a polyurethane scaffold. Two-year safety and clinical outcomes. Am J Sports Med. 2012; Feb 9. (Epub ahead of print).

    Google Scholar 

  34. Zorzi C, Condello V, Verdonk P, et al. Too old for regenerative treatment? Too young for joint replacement? Clinical indication for a novel meniscus implant. ICRS 2012 meeting, Montreal, Canada, 12–15 May 2012.

    Google Scholar 

  35. Adams M, Hukins D. The extracellular matrix of the meniscus. New York, Raven Press; 1992.

    Google Scholar 

  36. Khan I, Smith N, Jones E, et al. Analysis and evaluation of a biomedical polycarbonate urethane tested in an in vitro study and an ovine arthroplasty model. Part II: in vivo investigation. Biomaterials. 2005;26:633–43.

    Article  PubMed  CAS  Google Scholar 

  37. Scholes SC, Burgess IC, Marsden HR, et al. Compliant layer acetabular cups: friction testing of a range of materials and designs for a new generation of prosthesis that mimics the natural joint. Proc Inst Mech Eng [H]. 2006;220:583–96.

    Article  CAS  Google Scholar 

  38. Scholes SC, Unsworth A, Jones E. Polyurethane unicondylar knee prostheses: simulator wear tests and lubrication studies. Phys Med Biol. 2007;52:197–212.

    Article  PubMed  CAS  Google Scholar 

  39. Elleuch R, Elleuch K, Salah B, et al. Tribological behavior of thermoplastic polyurethane elastomers. Materials & Design. 2007;28:824–30.

    Article  CAS  Google Scholar 

  40. Pollanen R, Tikkanen AM, Lammi MJ, et al. The effect of loading and material on the biomechanical properties and vitality of bovine cartilage in vitro. J Appl Biomater Biomech. 2011;9(1):47–53.

    PubMed  Google Scholar 

  41. Elsner JJ, Mezape Y, Hakshur K, et al. Wear rate evaluation of a novel polycarbonate-urethane cushion form bearing for artificial hip joints. Acta Biomater. 2010a;6(12):4698–707.

    Article  CAS  Google Scholar 

  42. Elsner JJ, Bonner TF, Greenel A, et al. In-vitro stability testing of a non-fixed meniscal implant: the effect of surgical technique and knee condition. ICRS 2012 meeting, Montreal, Canada, 12–15 May 2012.

    Google Scholar 

  43. Elsner JJ, Portnoy S, Guilak F, et al. MRI-based characterization of bone anatomy in the human knee for size matching of a medial meniscal implant. J Biomech Eng. 2010b;132(10):101008.

    Article  Google Scholar 

  44. Elsner JJ, Linder-Ganz E, Zur G, et al. A Polycarbonate-urethane meniscal implant: size increments and population. ORS meeting, Las Vegas. 2009.

    Google Scholar 

  45. Linder-Ganz E, Elsner JJ, Danino A, et al. A novel quantitative approach for evaluating contact mechanics of meniscal replacements. J Biomech Eng. 2010;132(2):024501.

    Article  PubMed  CAS  Google Scholar 

  46. Elsner JJ, Portnoy S, Zur G, et al. Design of a free-floating polycarbonate-urethane meniscal implant using finite element modeling and experimental validation. J Biomech Eng. 2010c;132(9):095001.

    Article  Google Scholar 

  47. Zur G, Linder-Ganz E, Elsner JJ, et al. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):255–63.

    Article  PubMed  Google Scholar 

  48. Carlson CS, Guilak F, Vail TP, et al. Synovial fluid biomarker levels predict articular cartilage damage following complete medial meniscectomy in the canine knee. J Orthop Res. 2002;20:92–100.

    Article  PubMed  Google Scholar 

  49. Verdonk PC, Demurie A, Almqvist KF, et al. Transplantation of viable meniscal allograft. Survivorship analysis and clinical outcome of one hundred cases. J Bone Joint Surg Am. 2005;87:715–24.

    Article  PubMed  Google Scholar 

  50. Van Arkel ER, Boer HH de. Survival analysis of human meniscal transplantations. J Bone Joint Surg Br. 2002;84:227–31.

    Article  PubMed  CAS  Google Scholar 

  51. Noyes FR, Barber-Westin SD, et al. Meniscal transplantation in symptomatic patients less than fifty years old. J Bone Joint Surg Am. 2004;86-A:1392–1404.

    PubMed  Google Scholar 

  52. Kobayashi M, Toguchida J, Oka M. Development of an artificial meniscus using polyvinyl alcohol-hydrogel for early return to, and continuance of, athletic life in sportspersons with severe meniscus injury. II: animal experiments. Knee. 2003;10:53.

    Article  PubMed  Google Scholar 

  53. Chiari C, Koller U, Dorotka R, et al. A tissue engineering approach to meniscus regeneration in a sheep model. Osteoarthr Cartil. 2006;14:1056–65.

    Article  PubMed  CAS  Google Scholar 

  54. Buma P, Tienen T van, Veth R. The collagen meniscus implant. Expert Rev Med Devices. 2007;4:507–16.

    Article  PubMed  Google Scholar 

  55. Kelly BT, Robertson W, Potter HG, et al. Hydrogel meniscal replacement in the sheep knee: preliminary evaluation of chondroprotective effects. Am J Sports Med. 2007;35:43–52.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, Sacro Cuore Hospital, Sempreboni 5, 37024, Negrar VR, Italy

    Vincenzo Condello M.D.

  2. Department of Orthopaedic and Trauma Sciences, Hospital di Circolo, University of Insubria, Varese, Italy

    Mario Ronga M.D.

  3. Research and Development, Active Implants Corporation, Netanya, Israel

    Eran Linder-Ganz B.Sc., M.Sc., Ph.D.

  4. Orthopaedics, Sacro Cuore-Don Calabria Hospital, Negrar VR, Italy

    Claudio Zorzi M.D.

Authors
  1. Vincenzo Condello M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mario Ronga M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eran Linder-Ganz B.Sc., M.Sc., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudio Zorzi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vincenzo Condello M.D. .

Editor information

Editors and Affiliations

  1. OrthoIndy and Indiana Orthopedic Hospital, Indiana University School of Medicine, Greenwood, Indiana, USA

    Jack Farr

  2. Harvard Medical School, Brigham and Women's Hospital, Chestnut Hill, Massachusetts, USA

    Andreas H. Gomoll

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Condello, V., Ronga, M., Linder-Ganz, E., Zorzi, C. (2014). Alternatives to Meniscus Transplantation Outside the United States. In: Farr, J., Gomoll, A. (eds) Cartilage Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0427-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-0427-9_19

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0426-2

  • Online ISBN: 978-1-4614-0427-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation