Advertisement

Meniscal Augmentation and Replacement (Menaflex, Actifit, and NUsurface)

  • Aad Alfons Maria Dhollander
  • Vincenzo Condello
  • Vincenzo Madonna
  • Marco Bonomo
  • Peter Verdonk
Chapter

Abstract

In the last decades, the surgical treatment of meniscal injury or damage has shifted from a total meniscectomy to a partial meniscectomy or repair. Rather than a removal of meniscal tissue, the goal of novel surgical techniques is to preserve as much functional meniscal tissue as possible. Recently, attempts have been made to promote meniscal healing, as well as the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. This chapter will focus on meniscal augmentation and on three types of meniscal replacement devices. These substitutes are the biological Menaflex™ or collagen meniscal implant (CMI), the biomimetic Actifit™ meniscal scaffold, and the nonbiological NUsurface® meniscal substitute.

Keywords

Meniscus Menaflex™ CMI Actifit™ NUsurface™ Scaffold Meniscus Augmentation Meniscus implant Meniscus substitute 

References

  1. 1.
    Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med. 1982;10:90–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Maak TG, Fabricant PD, Wickiewicz TL. Indications for meniscus repair. Clin Sports Med. 2012;31:1–14.CrossRefPubMedGoogle Scholar
  3. 3.
    Moran CJ, Busilacchi A, Lee CA, Athanasiou KA, Verdonk PC. Biological augmentation and tissue engineering approaches in meniscus surgery. Arthroscopy. 2015;31:944–55.CrossRefPubMedGoogle Scholar
  4. 4.
    Scotti C, Hirschmann MT, Antinolfi P, Martin I, Peretti GM. Meniscus repair and regeneration: review on current methods and research potential. Eur Cell Mater. 2013;26:150–70.CrossRefPubMedGoogle Scholar
  5. 5.
    Jang SH, Ha JK, Lee DW, Kim JG. Fibrin clot delivery system for meniscal repair. Knee Surg Relat Res. 2011;23:180–3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ra HJ, Ha JK, Jang SH, Lee DW, Kim JG. Arthroscopic inside-out repair of complete radial tears of the meniscus with a fibrin clot. Knee Surg Sports Traumatol Arthrosc. 2013;21:2126–30.CrossRefPubMedGoogle Scholar
  7. 7.
    Vangsness CT Jr, Farr J II, Boyd J, Dellaero DT, Mills CR, Leroux-Williams M. Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014;96:90–8.CrossRefPubMedGoogle Scholar
  8. 8.
    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;20:104–11.CrossRefPubMedGoogle Scholar
  9. 9.
    Rodkey WG, Steadman JR, Li ST. A clinical study of collagen meniscus implants to restore the injured meniscus. Clin Orthop Relat Res. 1999;367:281–92.CrossRefGoogle Scholar
  10. 10.
    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;79:1770–7.CrossRefPubMedGoogle Scholar
  11. 11.
    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;39:977–85.CrossRefPubMedGoogle Scholar
  12. 12.
    Tienen TG, Heijkants RG, de GJH, et al. Replacement of the knee meniscus by a porous polymer implant: a study in dogs. Am J Sports Med. 2006;34:64–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Verdonk P, Verdonk R, Huysse W, 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;40:844–53.CrossRefPubMedGoogle Scholar
  14. 14.
    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;39:774–82.CrossRefPubMedGoogle Scholar
  15. 15.
    Dhollander A, Verdonk P, Verdonk R. Treatment of painful, irreparable partial meniscal defects with a polyurethane scaffold: midterm clinical outcomes and survival analysis. Am J Sports Med. 2016;44:2615–21.CrossRefPubMedGoogle Scholar
  16. 16.
    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
  17. 17.
    Elsner JJ, Portnoy S, Guilak F, Shterling A, Linder-Ganz E. MRI-based characterization of bone anatomy in the human knee for size matching of a medialmeniscal implant. J Biomech Eng. 2010;132:101008.CrossRefPubMedGoogle Scholar
  18. 18.
    Linder-Ganz E, Elsner JJ, Danino A, Guilak F, Shterling A. A novel quantitative approach for evaluating contact mechanics of meniscal replacements. J Biomech Eng. 2010;132:024501.CrossRefPubMedGoogle Scholar
  19. 19.
    Elsner JJ, Shemesh M, Shefy-Peleg A, Gabet Y, Zylberberg E, Linder-Ganz E. Quantification of in vitro wear of a synthetic meniscus implant using gravimetric and micro-CT measurements. J Mech Behav Biomed Mater. 2015;49:310–20.CrossRefPubMedGoogle Scholar
  20. 20.
    Elsner JJ, Portnoy S, Zur G, Guilak F, Shterling A, Linder-Ganz E. Design of a free-floating polycarbonate-urethane meniscal implant using finite element modeling and experimental validation. J Biomech Eng. 2010;132:095001.CrossRefPubMedGoogle Scholar
  21. 21.
    Zur G, Linder-Ganz E, Elsner JJ, Shani J, Brenner O, Agar G, Hershman EB, Arnoczky SP, Guilak F, Shterling A. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg Sports Traumatol Arthrosc. 2011;19:255–63.CrossRefPubMedGoogle Scholar
  22. 22.
    Shemesh M, Asher R, Zylberberg E, Guilak F, Linder-Ganz E, Elsner JJ. Viscoelastic properties of a synthetic meniscus implant. J Mech Behav Biomed Mater. 2014;29:42–55.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Aad Alfons Maria Dhollander
    • 1
  • Vincenzo Condello
    • 2
  • Vincenzo Madonna
    • 2
  • Marco Bonomo
    • 2
  • Peter Verdonk
    • 3
    • 4
  1. 1.Department of Orthopedic Surgery and TraumatologyAZ KLINABrasschaatBelgium
  2. 2.Department of Orthopedics and TraumatologySacro Cuore-Don Calabria HospitalNegrar (Verona)Italy
  3. 3.Antwerp Orthopedic Center, Monica HospitalsAntwerpBelgium
  4. 4.Department of Orthopedic Surgery, Antwerp University HospitalAntwerpBelgium

Personalised recommendations