The human meniscus: transplantation, characterisation and tissue engineering

The Human Meniscus: Transplantation, Characterization and Tissue Engineering Peter Verdonk, MD, PhD; Ghent University, Belgium Abstract The meniscus plays an important role in the complex biomechanics of the knee joint. Removal of this tissue can result in dysfunction and pain in the involved joint compartment and ultimately osteoarthritis. We report on the surgical technique, the clinical and radiological outcome after substitution of the human meniscus with a viable allograft. The results of this type of surgery are encouraging and long-lasting in a well-selected patient population who suffered a total meniscectomy. Viable meniscus allograft transplantation significantly reduces pain and improves function. This beneficial effect remains present in around 70% of the patients at 10 years after surgery. In light of the higher number of partial meniscectomies in the clinical office, further attention was paid to develop tissue engineering strategies to restore and regenerate meniscus tissue without the intrinsic drawback of the use of allogeneic material. A first study aimed at the characterization of the human meniscus cell associated matrix (CAM) synthesis and turnover in two different culture conditions. The alginate culture conditions appear to favor the fibrochondrocyte meniscus cells with a CAM rich in type I collagen and aggrecan and lower quantities of type II collagen, while monolayer cultured meniscus cells have considerable amounts of type I and II collagen but almost no aggrecan in their CAM. Additional investigations led to the description of a new cell-type within the superficial layer of the normal meniscus; the CD34+ meniscus cell. In a second study, we demonstrated that human bone marrow derived mesenchymal stem cells in combination with a type I collagen scaffold have a fibrochondrogenic differentiation potential. This cell-scaffold combination is implantable and could easily deliver autologous hBMSC with meniscus repair potential to the defect. The ultimate goal of meniscus transplantation and tissue engineering is to prevent the degenerative process induced by a partial or total meniscectomy and inflicted upon the articular cartilage. Therefore, metabolic pathways (IGF-1, IL-1, IL-1RII) were investigated in the articular chondrocyte that could be targeted by specific pharmaceuticals (polysulphated cyclodextrines) in order to upregulate an anabolic effect. The use of these substances could improve the results of meniscus substitution procedures in secondary osteoarthritic knee joints.

Author dc:creator

• Verdonk, Peter

Contributors dc:contributor

• Verbruggen, A

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

und

Identifier

https://biblio.ugent.be/publication/468974
http://doi.org/1854/6206
https://biblio.ugent.be/publication/468974/file/1878775

OAI identifier oai:identifier

oai:archive.ugent.be:468974