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An Allogenic Cell–Based Implant for Meniscal Lesions

Christian Weinand, MD, PhD^*, Giuseppe M. Peretti, MD^*,, Samuel B. Adams, Jr, MD^*, Lawrence J. Bonassar, PhD, Mark A. Randolph, MAS^*, and Thomas J. Gill, MD^*,||

From the ^* Laboratory for Musculoskeletal Tissue Engineering, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, San Raffaele Hospital, Università Vita-Salute, Milan, Italy, Cornell University, Sibley School of Mechanical and Aerospace Engineering, Ithaca, New York, and Plastic Surgery Research Laboratory, Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

^|| Address correspondence to Thomas J. Gill, MD, Massachusetts General Hospital, WACC 531, 15 Parkman Street, Boston, MA 02114 (e-mail: tgill{at}partners.org).

Background: Meniscal tears in the avascular zones do not heal. Although tissue-engineering approaches using cells seeded onto scaffolds could expand the indication for meniscal repair, harvesting autologous cells could cause additional trauma to the patient. Allogenic cells, however, could provide an unlimited amount of cells.

Hypothesis: Allogenic cells from 2 anatomical sources can repair lesions in the avascular region of the meniscus.

Study Design: Controlled laboratory study.

Methods: Both autologous and allogenic chondrocytes were seeded onto a Vicryl mesh scaffold and sutured into a bucket-handle lesion created in the medial menisci of 17 swine. Controls consisted of 3 swine knees treated with unseeded implants and controls from a previous experiment in which 4 swine were treated with suture only and 4 with no treatment. Menisci were harvested after 12 weeks and evaluated histologically for new tissue and percentage of interface healing surface; they were also evaluated statistically.

Results: The lesions were closed in 15 of 17 menisci. None of the control samples demonstrated healing. Histologic analysis of sequential cuts through the lesion showed formation of new scar-like tissue in all experimental samples. One of 8 menisci was completely healed in the allogenic group and 2 of 9 in the autologous group; the remaining samples were partially healed in both groups. No statistically significant differences in the percentage of healing were observed between the autologous and allogenic cell-based implants.

Conclusion: Use of autologous and allogenic chondrocytes delivered via a biodegradable mesh enhanced healing of avascular meniscal lesions.

Clinical Relevance: This study demonstrates the potential of a tissue-engineered cellular repair of the meniscus using autologous and allogenic chondrocytes.

Key Words: meniscus • repair • implant • autologous • allogenic • chondrocytes • tissue engineering • large-animal study