ABSTRACT
Recently, studies have emphasized the importance of anatomical placement of the lateral meniscal allograft to decrease postoperative extrusion. However, it is infeasible to identify the exact rotation of the allograft during transplantation. We present a patient who underwent a lateral meniscal transplantation using a wire for correct positioning of the allograft. The use of a wire intraoperatively shaped to resemble the contour of the lateral meniscal allograft will aid in more accurate and anatomical graft placement.
Subject(s)
Humans , Allografts , Menisci, Tibial , TransplantsABSTRACT
To evaluate the effects on the restoration of proprioception, we compared joint position sense (JPS) after meniscal allograft transplantation. Nine patients who underwent meniscal allograft transplantation between March 2008 and January 2010 were evaluated at preoperation and 6 months post-operation. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were evaluated. The peak torque of the isokinetic flexor and extensor strength test was performed using Biodex system III. Passive JPS was assessed to evaluate proprioceptive function. In the results, IKDC subjective score and Lysholm score were improved (p=0.05). The flexor and extensor power decreased, however there was no statistically significant difference. In the assessment of JPS, there was improvement from 6.56degrees and 4.11degrees to 4.89degrees and 1.89degrees, however, this was not statistically significant. Although, proprioception was improved in JPS at 6 months after meniscus transplantation, it did not show statistic significance. Therefore, future studies using combined methods will be needed to evaluate proprioceptive function after meniscal allograft transplantation.
Subject(s)
Humans , Joints , Knee , Proprioception , Torque , Transplantation, Homologous , TransplantsABSTRACT
No presente estudo foi avaliada a arquitetura tecidual, a população celular, assim como a integridade e a distribuição dos tipos celulares em meniscos frescos de coelhos e preservados em glicerina 98 por cento. Foram analisados meniscos mediais de coelhos recém abatidos, que foram distribuídos em três grupos: o grupo MF (n=7), composto por meniscos frescos, correspondeu ao grupo controle; o grupo MG (n=7), composto por meniscos preservados em glicerina 98 por cento, por 30 dias, e o grupo MR (n=7), por meniscos preservados em glicerina 98 por cento e reidratados em NaCl 0,9 por cento, por 12 horas. Em todos os meniscos foram identificados e quantificados os diferentes tipos celulares: fibroblastos/fibrócitos e condrócitos. A população celular foi estatisticamente semelhante nos três grupos de meniscos, sendo que os meniscos preservados, grupos MG e MR, apresentaram menor intensidade de coloração e retração das fibras colágenas, diminuição de volume e maior intensidade de coloração dos núcleos (condensação da cromatina), em relação aos meniscos frescos (MF), caracterizando o fenômeno de lise celular. A matriz fibrocartilaginosa dos meniscos preservados revelou- se bem preservada mantendo a arquitetura tecidual dos meniscos. Conclui-se que a glicerina 98 por cento é uma opção de meio de preservação para meniscos objetivando aloenxerto, com matriz colágena desvitalizada.
In the present study was evaluated the tissue architecture, the percentage of cellular population, as well as viability and distribution of cells in fresh menisci of rabbits and preserved in 98 percent glycerin. Were analyzed medial menisci of rabbits freshly slaughtered, which were distributed into three groups: the MF group (n=7), composed of fresh menisci, corresponded to the control group; the MG group (n=7), composed by menisci preserved in 98 percent glycerin, for 30 days, and the MR group (n=7) by menisci preserved in 98 percent glycerin and rehydrated in NaCl 0.9 percent for 12 hours. In all menisci were identified and quantified the different cell types: fibroblasts/fibrocytes and condrocytes. The cell population percentage was statistically similar in all groups. All menisci preserved in the MG and MR groups showed a lower intensity of color and shrinkage of collagen fibers, reduced volume and higher intensity of staining of nucleus (chromatin condensation), as compared to fresh menisci (MF), featuring the phenomenon of cell lysis. The cartilaginous matrix of preserved menisci proved to be well preserved because the tissue architecture was maintained. It was concluded that 98 percent glycerin is an optional preservation mean for meniscal allografts with a devitalized collagenous matrix.
Subject(s)
Animals , Menisci, Tibial/anatomy & histology , Organ Preservation Solutions , Glycerol , RabbitsABSTRACT
PURPOSE: We investigated the clinical results and MRI findings follow up after meniscal transplantation using fresh frozen meniscal allograft. MATERIAL AND METHODS: From Dec. 1999 to Dec. 2001, we evaluated 17 patients (12 cases: male, 5 cases: female) after meniscal transplantation using fresh frozen meniscal allograft. The patients performed the lateral meniscal transplantation were 12cases, the medial were 5cases. The average age was 32 years old (ranging from 19 to 50 years old), and was follow up period 18 months (ranging from 12 to 26 months). Among them we studied MRI findings in 16 patients and the postop-period was 16.9 months (ranging from 5 to 26 months). We analyzed the clinical data by applying KASS(knee assessment scoring system) & Lysholm knee score, and rehabilitation ability using of Tegner activity scale. It investigated the retrogressive changes of joint effusion, misfortune degree of meniscal location, intensity, tear and degenerative change which was made from the MRI. RESULTS: The follow up mean KASS score and Lysholm score were 84.3 (ranging from 61 to 94), and 81.1 (ranging from 63 to 90). Among the 17 patients, 15 patients showed good results. But painful swellings were 2 cases and intermitent locking symtom was 1 case. The MRI findings were 14 cases increasing signal intensity, 2 cases peripheral displacement, 2 cases partial meniscal tear and some degree effusions of 13 cases. CONCLUSION: The meniscal transplantation using fresh frozen allogrft came to be thought with the surgical method which improved the function of knee joint after operating it brought a successful result from the MRI.
Subject(s)
Adult , Humans , Male , Allografts , Follow-Up Studies , Joints , Knee , Knee Joint , Magnetic Resonance Imaging , RehabilitationABSTRACT
In this study, we have investigated the use of cryopreserved menisci to orthotopically replace the medial menisci in adult beagle dogs. Red cell group typing and white blood cell group typing were determined and beagles were divided into the blood-matching group and the non-matching group. The medial meniscus was replaced with an allograft meniscus that had been preserved at -70 degrees for 7-21 days. As a control, the medial meniscus was removed and reattached after cryopreservation. Replaced menisci were examined macroscopicaly, histologicaly and biochemicaly at an interval of 2 weeks, 1, 3, 6, 12 months postoperatively.<BR>After 6 months, the transplanted menisci had completely healed macroscopicaly. However, chondral erosions of the medial tibial plateau were seen in about one-half of the transplanted knees, and were thought to be caused by improper fixation of the anterior or posterior meniscal horns.<BR>At 12 weeks, an infiltration of fibroblasts and capillaries from the synovial fringe into the meniscus were seen histoloigicaly. The central core of the menisci remained acellular. At 12 months, regenerated chondrocytes in the deep layer and fibrocartilage were seen in the macroscopical good allografted group. In the macroscopical poor group, the extracellular matrix of the meniscus was destroyed and the empty lacunae were presented.<BR>The water content of the macroscopical poor group was significantly greater than that of the control group. In the good group the collagen content was siginificantly greater than that of the poor group.<BR>There were no differences between the blood matching group and the non-matching group macroscopicaly, histologicaly and biochemicaly.
ABSTRACT
In this study, we have investigated the use of cryopreserved menisci to orthotopically replace the medial menisci in adult beagle dogs. Red cell group typing and white blood cell group typing were determined and beagles were divided into the blood-matching group and the non-matching group. The medial meniscus was replaced with an allograft meniscus that had been preserved at -70 degrees for 7-21 days. As a control, the medial meniscus was removed and reattached after cryopreservation. Replaced menisci were examined macroscopicaly, histologicaly and biochemicaly at an interval of 2 weeks, 1, 3, 6, 12 months postoperatively.<BR>After 6 months, the transplanted menisci had completely healed macroscopicaly. However, chondral erosions of the medial tibial plateau were seen in about one-half of the transplanted knees, and were thought to be caused by improper fixation of the anterior or posterior meniscal horns.<BR>At 12 weeks, an infiltration of fibroblasts and capillaries from the synovial fringe into the meniscus were seen histoloigicaly. The central core of the menisci remained acellular. At 12 months, regenerated chondrocytes in the deep layer and fibrocartilage were seen in the macroscopical good allografted group. In the macroscopical poor group, the extracellular matrix of the meniscus was destroyed and the empty lacunae were presented.<BR>The water content of the macroscopical poor group was significantly greater than that of the control group. In the good group the collagen content was siginificantly greater than that of the poor group.<BR>There were no differences between the blood matching group and the non-matching group macroscopicaly, histologicaly and biochemicaly.