A Hydrogel Meniscal Replacement: Knee Joint Pressure and Distribution in an Ovine Model Compared to Native Tissue
- 302 Downloads
Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint. No treatment condition tested within this study was able to fully restore medial joint contact area and pressures to the native condition. A decrease in lateral contact area and increase in pressures with the meniscectomy was also seen; and to some degree, all reattachment and replacement conditions including the novel TPE hydrogel replacement helped to restore lateral pressures. Although the TPE construct did not perform as well as hoped in the medial compartment, it performed as well as, if not better, than the other reattachment and replacement options in the lateral. Further work is necessary to determine the best anchoring and attachment methods.
KeywordsOsteoarthritis Meniscectomy Allograft Reattachment Tekscan Pressure mapping Thermoplastic elastomer polymer
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number R21 AR069826. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Conflict of interest
The authors have a patent Soft Tissue Mimetics and Thermoplastic Elastomer Hydrogels pending, and a patent Thermoplastic Elastomer Hydrogels pending.
- 3.Bouyarmane, H., P. Beaufils, N. Pujol, J. Bellemans, S. Roberts, T. Spalding, S. Zaffagnini, M. Marcacci, P. Verdonk, M. Womack, and R. Verdonk. Polyurethane scaffold in lateral meniscus segmental defects: clinical outcomes at 24 months follow-up. Orthop. Traumatol. Surg. Res. 100:153–157, 2014.CrossRefGoogle Scholar
- 5.Brophy, R. H., J. Cottrell, S. A. Rodeo, T. M. Wright, R. F. Warren, and S. A. Maher. Implantation of a synthetic meniscal scaffold improves joint contact mechanics in a partial meniscectomy cadaver model. J. Biomed. Mater. Res. A 92:1154–1161, 2010.Google Scholar
- 18.Herregodts, S., P. De Baets, J. Victor, and M. A. Verstraete. Use of Tekscan pressure sensors for measuring contact pressures in the human knee joint. Sustain. Constr. Des. 6(2):8–10, 2005.Google Scholar
- 20.Kon, E., G. Filardo, M. Tschon, M. Fini, G. Giavaresi, L. M. Reggiani, C. Chiari, S. Nehrer, I. Martin, D. M. Salter, L. Ambrosio, and M. Marcacci. Tissue engineering for total meniscal substitution: animal study in sheep model–results at 12 months. Tissue Eng. Part A 18:1573–1582, 2012.CrossRefGoogle Scholar
- 26.Radin, E. L., F. de Lamotte, and P. Maquet. Role of the menisci in the distribution of stress in the knee. Clin. Orthop. Relat. Res. 185:290–294, 1984.Google Scholar
- 30.Sun, J., S. Vijayavenkataraman, and H. Liu. An overview of scaffold design and fabrication technology for engineered knee meniscus. Materials (Basel) 10:1–19, 2017.Google Scholar
- 37.Welsing, R. T. C., T. G. van Tienen, N. Ramrattan, R. Heijkants, A. J. Schouten, R. P. H. Veth, and P. Buma. Effect on tissue differentiation and articular cartilage degradation of a polymer meniscus implant: a 2-year follow-up study in dogs. Am. J. Sports Med. 36:1978–1989, 2008.CrossRefGoogle Scholar
- 39.Zur, G., E. Linder-Ganz, J. J. Elsner, J. Shani, O. Brenner, G. Agar, E. B. Hershman, S. P. Arnoczky, F. Guilak, and A. Shterling. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg. Sport. Traumatol. Arthrosc. 19:255–263, 2011.CrossRefGoogle Scholar