Porous Polymer Prosthesis for Meniscal Regeneration

Meniscus is the most commonly injured structure in the knee joint. Resection of the meniscus as well as the torn menisci is known to induce the degeneration of the articular cartilage. Replacement of the resected meniscus by allograft is limited by its availability and potential disease transmission. Artificial prostheses are being tried in an attempt to regenerate the meniscal tissue and we developed the biodegradable porous polycaprolactone(PCL) scaffold, which acts as a temporary scaffold to enable the regeneration of a new tissue in time. We report the results of rabbit implantation model. Biodegradable PCL scaffold coated with type I collagen with pores sized 100~150 +m and with compression modulus 400 kpa were fabricated by melt-molding particulate- leaching method. The molds were made using the native meniscus of the rabbit. Medial meniscus of right knee was partially removed through arthrotomy, leaving anterior 1/5 of the meniscus, after sectioning medial collateral ligament. The implant was attached to the peripheral capsule and remnant anterior meniscus with sutures. The medial meniscus of the left knee was removed and served as a control without replacement. The regenerated meniscus was harvested at 4 & 12wks after implantation. In addition to the routine histology of the tissue regenerated and remnant scaffold, junction between the normal meniscus and the regenerated tissue, and cartilage surface degeneration was observed. After 4 and 12 weeks the scaffolds, although considerable amount of the materials remained, were largely filled and covered with fibrous tissue which was assumed to be derived from synovial tissue of peripheral capsule. The tissue grossly resembling the native meniscus was maintained and spindle shaped cells with extracellular matrices were observed histologically. Neither cells with chondrocytic phenotype nor distinct cartilage matrices were observed until 12 weeks. The bonding between the regenerated tissue and the peripheral synovial capsule was firm and solid in all cases. The tissue bridges between the native meniscus and the regenerated tissue were found in 9/10 operated knees. Articular surface degeneration was not different between experimental and control groups except one case. More or less, the extrusion of the meniscus was found in almost all knees. This study revealed that meniscal replacement with PCL polymer prosthesis was feasible and led to adequate tissue formation. Long term studies on adaptive remodeling will be required.