Meniscectomy can lead to degenerative joint changes in the knee. CMI is a tissue engineering technique designed to stimulate regeneration of meniscal tissue in case of irreparabile tears or previous meniscectomy. It is composed of type I collagen derived from bovine Achilles tendon and enriched with glycosaminoglycans. Previous clinical trials demonstrated satisfactory medium term results in patients treated with CMI. In this study, CMI structure was analysed by light microscopy and SEM. The same morphological studies were performed on two implant biopsies, carried out on two patients who underwent a second arthroscopic look six months after implantation. The evolution of the implant was also investigated by MRI, six and twelve months postoperatively. CMI presents a multilamellar structure, with inner lacunae allowing tissue ingrowth. The lamellae are made of collagen fibrils, randomly oriented and preserving the typical 64 nm period. At second arthroscopic look, the implant appeared in continuity to the native residual meniscus and parameniscus, and showed good consistency and stability at probing. The biopsy specimens demonstrated invasion of the scaffold by connective tissue and blood vessels. The newly synthesised collagen fibrils were clearly distinguishable from the scaffold ones. No phagocito-macrophagic cells and any inflammatory reaction were observed inside the implant. MRI findings confirmed CMI biocompatibility and highlighted the evolution of the integration process with time. The data achieved in this study support the hypotesis that CMI can stimulate regeneration of meniscal-like tissue, which could prevent the development of degenerative changes after meniscectomy.
Short-term evaluation of collagen meniscus implants (CMI) by MRI and morphological analysis.
RONGA, MARIO;GENOVESE, EUGENIO ANNIBALE;GRASSI, FEDERICO ALBERTO;CHERUBINO, PAOLO
2003-01-01
Abstract
Meniscectomy can lead to degenerative joint changes in the knee. CMI is a tissue engineering technique designed to stimulate regeneration of meniscal tissue in case of irreparabile tears or previous meniscectomy. It is composed of type I collagen derived from bovine Achilles tendon and enriched with glycosaminoglycans. Previous clinical trials demonstrated satisfactory medium term results in patients treated with CMI. In this study, CMI structure was analysed by light microscopy and SEM. The same morphological studies were performed on two implant biopsies, carried out on two patients who underwent a second arthroscopic look six months after implantation. The evolution of the implant was also investigated by MRI, six and twelve months postoperatively. CMI presents a multilamellar structure, with inner lacunae allowing tissue ingrowth. The lamellae are made of collagen fibrils, randomly oriented and preserving the typical 64 nm period. At second arthroscopic look, the implant appeared in continuity to the native residual meniscus and parameniscus, and showed good consistency and stability at probing. The biopsy specimens demonstrated invasion of the scaffold by connective tissue and blood vessels. The newly synthesised collagen fibrils were clearly distinguishable from the scaffold ones. No phagocito-macrophagic cells and any inflammatory reaction were observed inside the implant. MRI findings confirmed CMI biocompatibility and highlighted the evolution of the integration process with time. The data achieved in this study support the hypotesis that CMI can stimulate regeneration of meniscal-like tissue, which could prevent the development of degenerative changes after meniscectomy.
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