Meniscal allograft transplants and new scaffolding techniques

[摘要] Injuries of the meniscus are probably the most frequent injuries occuring in the knee.1 According to the statement from Prof. René Verdonk, ‘Nothing has changed so much in recent years of orthopedics as the treatment algorithm of meniscus lesions’.2 A radical change occurred since the ‘recommendation’ during the 1970s to remove as much as possible of what was formerly considered as a useless structure,3 to the present-day movement supporting the preservation, repair or replacement of the meniscus.2 Recent basic science research reinforced the claim that the menisci are fundamental components of a healthy knee joint.4–6 Menisci are C-shaped fibro-cartilage structures with a wedge-like cross-section (Fig. 1), present between each tibial plateau and the corresponding femoral condyle.5,7 They have a specific extracellular matrix,8,9 multiple cell types10,11 and particular cell distribution.5,12 They Meniscal allograft transplants and new scaffolding techniques Hélder Pereira1,2,3,4,5 Ibrahim Fatih Cengiz4,5 Sérgio Gomes3 João Espregueira-Mendes4,5,6,7 Pedro L. Ripoll2 Joan C. Monllau8 Rui L. Reis4,5,9 J. Miguel Oliveira4,5,8,9 4.1801EOR0010.1302/2058-5241.4.180103 research-article2019 Instructional Lecture: Sports & Arthroscopy 280 have unique biomechanical features13 and are known to have segmental and regional variations concerning ultrastructure, vascularity, biology, and function.7,12,13 There are differences between the medial and the lateral menisci in knee kinematics. The lateral meniscus is accountable for most of the load transfer within the lateral compartment (around 70%),14 while the transmission of loading is more equally dispersed through the cartilage surfaces and the medial meniscus (50%) in the medial compartment.15,16 Concerning kinematics, the lateral meniscus is more mobile, while the medial one is more static to resist anterior tibial translation, acting as a secondary agonist of the anterior cruciate ligament (ACL).

[学科分类] 神经科学

[关键词] meniscal repair;meniscectomy;meniscus allograft transplantation (MAT);partial meniscus replacement;scaffold;tissue engineering and regenerative medicine