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General Orthopaedics

*Partial Meniscal Replacement With a Silk Scaffold in Sheep: Six-Month Results

International Society for Technology in Arthroplasty (ISTA)



Abstract

INTRODUCTION:

To avoid the early onset of osteoarthritis after partial meniscectomy an effective replacement of injured meniscal tissue would be desirable. The present study investigates the behaviour of a new silk derived scaffold supplied by Orthox Ltd. (Abingdon, UK) in an in vivo sheep model.

METHODS:

The scaffolds where derived from silk fibres by processing into an open porous matrix. Nine sheep (4 ± 1 years) underwent partial meniscectomy at the anterior horn of the medial meniscus followed by implantation of a scaffold. The unoperated contralateral stifle joint served as control.

After six months the animals were sacrificed and the joints inspected for inflammation. The Young's modulus of the tibial cartilage, meniscus and scaffold was determined by indentation or confined compression tests. All tissues were fixed in formaldehyde for histology. The data were analysed by a Wilcoxon and Mann-Whitney-U-test.

RESULTS:

The sheep were free of lameness 4 days p.o. The macroscopic analysis of the genual region and of the synovial membrane showed no signs of inflammation. This was confirmed by histological sections of synovial membrane, meniscus and scaffold. In histology, amorphous material, some fibroblast-like cell clusters and connective tissue formation was visible inside the pores of the scaffold. There were no statistically significant differences between the Young's moduli of the three measuring points in the operated and unoperated stifle joints.

The meniscal tissue showed a higher modulus than the scaffolds. The scaffold's modulus significantly increased after three months implantation.

DISCUSSION & CONCLUSIONS:

The presented silk scaffold withstood the loads occurring during the six months implantation period. It showed promising properties concerning biocompatibility and cartilage protection and its mechanical properties started to approach those of meniscal tissue.


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