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This Article Full Text Full Text (PDF) All Versions of this Article: 36/5/841    most recent 0363546507313089v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by von Lewinski, G. Articles by Lazovic, D. PubMed PubMed Citation Articles by von Lewinski, G. Articles by Lazovic, D. Related Collections Animal studies Chondral/cartilage Meniscus

The Influence of Nonanatomical Insertion and Incongruence of Meniscal Transplants on the Articular Cartilage in an Ovine Model

Gabriela von Lewinski, MD, PhD^,*, Dieter Kohn, MD, PhD, Carl Joachim Wirth, MD, PhD and Djordje Lazovic, MD, PhD

From the Orthopaedic Department, Hannover Medical School, Hannover, the Orthopaedic Department, University Homburg/Saar, and the Orthopaedic Department, Pius-Hospital Oldenburg, Germany

^* Address correspondence to Gabriela von Lewinski, MD, PhD, Orthopaedic Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, D-30625 Hannover, Germany (e-mail: gabriela.von.lewinski{at}annastift.de).

Background: Adequate size matching and anatomically correct positioning must be recognized as essential factors influencing the outcome of meniscal transplantation.

Hypothesis: Nonanatomical insertion and incongruence of meniscal transplants has an influence on the development of degenerative changes.

Study Design: Controlled laboratory study.

Methods: Ten female sheep were used for this animal study. Both knees (N = 20) were divided into 3 groups, subjected to either meniscectomy (group I; n = 10), to a medial meniscal autograft transplantation with a nonanatomical insertion of the anterior and posterior horn (group II; n = 5), or a meniscal autograft transplantation from the opposite knee as an incongruent meniscal autograft (group III; n = 5). After 6 months, radiographic (Fairbank’s criteria), macroscopic (Jackson score), and histological evaluation by light microscopy (Mankin score) and scanning electron microscopy of the articular cartilage was performed.

Results: All applied evaluation methods demonstrated that nonanatomical insertion of meniscal transplants resulted in the highest amount of degenerative cartilage changes. The histological assessment even revealed a significantly enlarged cartilage damage for the non-anatomic–positioned meniscal transplants in relation to the meniscectomized knees. Furthermore, the incongruent meniscal transplants demonstrated a significantly better cartilage situation than nonanatomically inserted meniscal transplants.

Conclusion: The histological evaluation demonstrated clearly that a nonanatomically inserted meniscal transplant leads to degenerative cartilage changes that are worse than that after meniscectomy.

Clinical Relevance: Precise anatomic positioning is mandatory for the potential chondroprotective effect of meniscal transplants.

Key Words: meniscus • meniscal transplantation • chondroprotective effect • cartilage