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Performance of a Sterile Meniscal Allograft in an Ovine Model

  • Original Article
  • Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Meniscus transplantation is indicated for persistent pain in a meniscectomized knee. Currently, grafts are prepared aseptically, which provides limited protection against donor-derived infection. The performance of a novel, sterilized meniscus was compared with an aseptically prepared one in an experimental model. Twenty-two sheep were divided into three groups: aseptic meniscal allograft, sterile meniscal allograft, and medial meniscectomy. Animals were euthanized 2 and 4 months after surgery. Meniscal assessments included cell viability, histology, and biomechanical testing. Articular cartilage was evaluated through histology and Outerbridge scoring. Aseptic and sterile allografts had cell viabilities of 59.7% and 58.7%, respectively, at 4 months, which was less than native controls. Grafts had decreased compressive strength at 4 months compared with their preimplantation moduli and were weaker than native menisci. In operated knees, the tibial plateau had more severe degenerative changes, although Outerbridge scores were similar between operated groups. Overall, the allografts were similar in their cellularity and biomechanical properties but were inferior to the native tissue at these end points. The severity of chondral damage in the allograft knees could not be distinguished from meniscectomized joints. The sterilization process does not appear to compromise tissue integrity and provides additional allograft safety.

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Fig. 1A–D
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Fig. 5A–D

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References

  1. Aagaard H, Jorgensen U, Bojsen-Moller F. Reduced degenerative articular cartilage changes after meniscal allograft transplantation in sheep. Knee Surg Sports Traumatol Arthrosc. 1999;7:184–191.

    Article  PubMed  CAS  Google Scholar 

  2. Aagaard H, Jorgensen U, Bojsen-Moller F. Immediate versus delayed meniscal allograft transplantation in sheep. Clin Orthop Relat Res. 2003;406:218–227.

    Article  PubMed  Google Scholar 

  3. Alford JW, Lewis P, Kang RW, Cole BJ. Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy. Arthroscopy. 2005;21:1505–1509.

    PubMed  Google Scholar 

  4. Alhalki MM, Howell SM, Hull ML. How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med. 1999;27:320–328.

    PubMed  CAS  Google Scholar 

  5. Arnoczky SP, DiCarlo EF, O’Brien SJ, Warren RF. Cellular repopulation of deep-frozen meniscal autografts: an experimental study in the dog. Arthroscopy. 1992;8:428–436.

    PubMed  CAS  Google Scholar 

  6. Elliott DM, Guilak F, Vail TP, Wang JY, Setton LA. Tensile properties of articular cartilage are altered by meniscectomy in a canine model of osteoarthritis. J Orthop Res. 1999;17:503–508.

    Article  PubMed  CAS  Google Scholar 

  7. Elliott DM, Jones R 3rd, Setton LA, Scully SP, Vail TP, Guilak F. Joint degeneration following meniscal allograft transplantation in a canine model: mechanical properties and semiquantitative histology of articular cartilage. Knee Surg Sports Traumatol Arthrosc. 2002;10:109–118.

    Article  PubMed  Google Scholar 

  8. Fabbriciani C, Lucania L, Milano G, Schiavone Panni A, Evangelisti M. Meniscal allografts: cryopreservation vs deep-frozen technique: an experimental study in goats. Knee Surg Sports Traumatol Arthrosc. 1997;5:124–134.

    Article  PubMed  CAS  Google Scholar 

  9. Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30:664–670.

    Google Scholar 

  10. Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res. 1990;252:19–31.

    PubMed  Google Scholar 

  11. Graf KW Jr, Sekiya JK, Wojtys EM. Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-year follow-up study. Arthroscopy. 2004;20:129–140.

    PubMed  Google Scholar 

  12. Jackson DW, McDevitt CA, Simon TM, Arnoczky SP, Atwell EA, Silvino NJ. Meniscal transplantation using fresh and cryopreserved allografts: an experimental study in goats. Am J Sports Med. 1992;20:644–656.

    Article  PubMed  CAS  Google Scholar 

  13. Jackson DW, Whelan J, Simon TM. Cell survival after transplantation of fresh meniscal allografts: DNA probe analysis in a goat model. Am J Sports Med. 1993;21:540–550.

    Article  PubMed  CAS  Google Scholar 

  14. Jackson DW, Windler GE, Simon TM. Intraarticular reaction associated with the use of freeze-dried, ethylene oxide-sterilized bone-patella tendon-bone allografts in the reconstruction of the anterior cruciate ligament. Am J Sports Med. 1990;18:1–10; discussion 10–11.

    Article  PubMed  CAS  Google Scholar 

  15. Jones DB, Huddleston PM, Zobitz ME, Stuart MJ. Mechanical properties of patellar tendon allografts subjected to chemical sterilization. Arthroscopy. 2007;23:400–404.

    PubMed  Google Scholar 

  16. Kelly BT, Potter HG, Deng XH, Pearle AD, Turner AS, Warren RF, Rodeo SA. Meniscal allograft transplantation in the sheep knee: evaluation of chondroprotective effects. Am J Sports Med. 2006;34:1464–1477.

    Article  PubMed  Google Scholar 

  17. Lazovic D, Wirth CJ, Knosel T, Gosse F, Maschek HG. [Meniscus replacement using incongruent transplants: an experimental study][in German]. Z Orthop Ihre Grenzgeb. 1997;135:131–137.

    Article  PubMed  CAS  Google Scholar 

  18. Lee SJ, Aadalen KJ, Malaviya P, Lorenz EP, Hayden JK, Farr J, Kang RW, Cole BJ. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med. 2006;34:1334–1344.

    Article  PubMed  Google Scholar 

  19. Mankin HJ, Dorfman H, Lippiello L, Zarins A. Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips: II. Correlation of morphology with biochemical and metabolic data. J Bone Joint Surg Am. 1971;53:523–537.

    PubMed  CAS  Google Scholar 

  20. McAllister DR, Joyce MJ, Mann BJ, Vangsness CT Jr. Allograft update: the current status of tissue regulation, procurement, processing, and sterilization. Am J Sports Med. 2007;35:2148–2158.

    Article  PubMed  Google Scholar 

  21. Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscus transplantation: experimental and clinical results. Int Orthop. 1989;13:1–11.

    Article  PubMed  CAS  Google Scholar 

  22. Mills CR, Roberts MR. BioCleanse tissue processing system: biological safety [technical monograph]. Alachua, FL: Regeneration Technologies, Inc; March 30, 2000. Available at: www.endoplus.nl/userpdf/BioCleanseTissueProcessingSystem.pdf. Accessed July 27, 2008.

  23. Mora G, Alvarez E, Ripalda P, Forriol F. Articular cartilage degeneration after frozen meniscus and Achilles tendon allograft transplantation: experimental study in sheep. Arthroscopy. 2003;19:833–841.

    PubMed  Google Scholar 

  24. Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961;43:752–757.

    PubMed  Google Scholar 

  25. Paletta GA Jr, Manning T, Snell E, Parker R, Bergfeld J. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee: a biomechanical study. Am J Sports Med. 1997;25:692–698.

    Article  PubMed  Google Scholar 

  26. Rijk PC. Meniscal allograft transplantation. Part I: background, results, graft selection and preservation, and surgical considerations. Arthroscopy. 2004;20:728–743.

    PubMed  Google Scholar 

  27. Rodeo SA. Meniscal allografts: where do we stand? Am J Sports Med. 2001;29:246–261.

    PubMed  CAS  Google Scholar 

  28. Schimizzi A, Wedemeyer M, Odell T, Thomas W, Mahar AT, Pedowitz R. Effects of a novel sterilization process on soft tissue mechanical properties for anterior cruciate ligament allografts. Am J Sports Med. 2007;35:612–616.

    Article  PubMed  Google Scholar 

  29. Shibuya S. Meniscus transplantation using a cryopreserved allograft. Histological and ultrastructural study of the transplanted meniscus. J Orthop Sci. 1999;4:135–141.

    Article  PubMed  CAS  Google Scholar 

  30. Szomor ZL, Martin TE, Bonar F, Murrell GA. The protective effects of meniscal transplantation on cartilage: an experimental study in sheep. J Bone Joint Surg Am. 2000;82:80–88.

    PubMed  CAS  Google Scholar 

  31. Tomita F, Yasuda K, Mikami S, Sakai T, Yamazaki S, Tohyama H. Comparisons of intraosseous graft healing between the doubled flexor tendon graft and the bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction. Arthroscopy. 2001;17:461–476.

    Article  PubMed  CAS  Google Scholar 

  32. van Arkel ER, de Boer HH. Survival analysis of human meniscal transplantations. J Bone Joint Surg Br. 2002;84:227–231.

    Article  PubMed  Google Scholar 

  33. Verma NN, Kolb E, Cole BJ, Berkson MB, Garretson R, Farr J, Fregly B. The effects of medial meniscal transplantation techniques on intra-articular contact pressures. J Knee Surg. 2008;21:20–26.

    PubMed  Google Scholar 

  34. Wirth CJ, Peters G, Milachowski KA, Weismeier KG, Kohn D. Long-term results of meniscal allograft transplantation. Am J Sports Med. 2002;30:174–181.

    PubMed  Google Scholar 

  35. Yahia L, Zukor D. Irradiated meniscal allotransplants of rabbits: study of the mechanical properties at six months postoperation. Acta Orthop Belg. 1994;60:210–215.

    PubMed  CAS  Google Scholar 

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Acknowledgments

We thank David Karwo, Adam Yanke, Predrag Bursac, and Lauren Brown for technical assistance.

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Authors and Affiliations

  1. Department of Anatomy and Cell Biology, Rush University Medical Center, 600 S Paulina, Suite 507AAC, Chicago, IL, 60612, USA

    Allison G. McNickle MS, Brian J. Cole MD, MBA & James M. Williams PhD

  2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Allison G. McNickle MS, Vincent M. Wang PhD, Elizabeth F. Shewman MS & Brian J. Cole MD, MBA

Authors
  1. Allison G. McNickle MS
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  2. Vincent M. Wang PhD
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  3. Elizabeth F. Shewman MS
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  4. Brian J. Cole MD, MBA
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Corresponding author

Correspondence to James M. Williams PhD.

Additional information

One or more of the authors (VMW, BJC, JMW) has received funding from RTI-Biologics (Alachua, FL).

Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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McNickle, A.G., Wang, V.M., Shewman, E.F. et al. Performance of a Sterile Meniscal Allograft in an Ovine Model. Clin Orthop Relat Res 467, 1868–1876 (2009). https://doi.org/10.1007/s11999-008-0567-y

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  • DOI: https://doi.org/10.1007/s11999-008-0567-y

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