Advertisement

Knee Meniscus Injury: Insights on Tissue engineering Strategies Through Retrospective Analysis and In Silico Modeling

  • Pillai M. Mamatha
  • Janarthanan Gopinathan
  • Venugopal Elakkiya
  • M. Sathishkumar
  • S. R. Sundarrajan
  • K. Santhosh Sahanand
  • Amitava BhattacharyyaEmail author
  • Rajendran SelvakumarEmail author
Review Article
  • 7 Downloads

Abstract

The present work focuses on three main aspects such as (1) extent of surgically managed human meniscal injury problem among the selected population (patients underwent meniscectomy), (2) viability of meniscus cells (isolated from surgical debri) at different age groups, and (3) simulation studies on model scaffolds to understand the biomechanical aspects. Thus, this study gives insights on the severity of the knee meniscus injury in the selected region and tissue engineering aspects which can in turn help in the design and development tissue-engineered construct for the regeneration of damaged tissue. Total 1025 patients (who underwent knee surgery related to meniscal injuries) data were collected from 2012 to 2015. With available additional data, main population was subdivided into two subpopulations. Retrospective and predictive statistical analyses using different statistical tools were performed for gender, age groups, causes of injury, symptoms, pre-treatment symptomatic duration, location of injury, and treatment given. Medium active persons with 23–28 BMI had shown more meniscus damage occurrences in subpopulation 2 (n = 316). 125 meniscus surgical debrises were collected and cells were isolated from the samples to analyze the cell count in each age group. This study showed that as age increases, cell viability was found to be decreased. In this study using simulation studies, the stress distribution against varying applied load was analyzed using COMSOL MULTIPHYSICS (version 4.3b). For this study, two different model scaffold systems were used such as poly(methyl methacrylate) (PMMA) and silicone. This approach can be a strong foundation for the development implantable scaffolds with biomechanical properties comparable to human meniscus.

Keywords

Meniscus injury Meniscectomy Epidemiological analysis Cell viability In silico modeling 

Notes

Acknowledgements

The authors like to express their deep gratitude to the management of PSG Institutions and Tamil Nadu State Council for Science and Technology (TNSCST), India for their financial and other shapes of support to carry out this work. We appreciate the support, guidance, and contribution from Dr. P. Radhakrishnan, Director, Dr. T. Lazar Mathew, Advisor, PSG Institute of Advanced Studies, Dr. David V. Rajan, Ortho One Orthopaedic Speciality Centre, and Dr. Ramalingam, PSG IMS&R, Coimbatore. The authors are thankful to Ganga Hospital, Coimbatore, staffs for giving access to the patient records.

Compliance with ethical standards

Conflict of Interest

All authors declare that they have no conflict of interest.

References

  1. 1.
    Torn meniscus, Website 2017 [cited on 07.02.2017]. https://www.gstatic.com/healthricherkp/pdf/torn_meniscus_en_IN.pdf
  2. 2.
    John R, Dhillon MS, Syam K, Prabhakar S, Behera P, Singh H (2016) Epidemiological profile of sports-related knee injuries in northern India: An observational study at a tertiary care centre. J Clin Orthop Trauma 7(3):207–211CrossRefGoogle Scholar
  3. 3.
    Jacob KM, Oommen AT (2012) A retrospective analysis of risk factors for meniscal co-morbidities in anterior cruciate ligament injuries. Indian J Orthop 46(5):566CrossRefGoogle Scholar
  4. 4.
    Frizziero A, Ferrari R, Giannotti E, Ferroni C, Poli P, Masiero S (2012) The meniscus tear: state of the art of rehabilitation protocols related to surgical procedures. Muscles Ligaments Tendons J 2(4):295Google Scholar
  5. 5.
    Murrell GA, Maddali S, Horovitz L, Oakley SP, Warren RF (2001) The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss. Am J Sports Med 29(1):9–14CrossRefGoogle Scholar
  6. 6.
    Maher SA, Rodeo SA, Potter HG, Bonassar LJ, Wright TM, Warren RF (2011) A pre-clinical test platform for the functional evaluation of scaffolds for musculoskeletal defects: the meniscus. HSS J 7(2):157–163CrossRefGoogle Scholar
  7. 7.
    BMI Calulator, U.S. Department of Health & Human Services. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/
  8. 8.
    Bijnen FC, Caspersen CJ, Feskens EJ, Saris WH, Mosterd WL, Kromhout D (1998) Physical activity and 10-year mortality from cardiovascular diseases and all causes: the Zutphen Elderly Study. Arch Intern Med 158(14):1499–1505CrossRefGoogle Scholar
  9. 9.
    Pillai MM, Elakkiya V, Gopinathan J, Sabarinath C, Shanthakumari S, Sahanand KS, Rai BD, Bhattacharyya A, Selvakumar R (2016) A combination of biomolecules enhances expression of E-cadherin and peroxisome proliferator-activated receptor gene leading to increased cell proliferation in primary human meniscal cells: an in vitro study. Cytotechnology 68(5):1747–1761CrossRefGoogle Scholar
  10. 10.
    Thompson WO, Fu FH (1993) The meniscus in the cruciate-deficient knee. Clin Sports Med 12(4):771–796Google Scholar
  11. 11.
    Fauno P, Nielsen AB (1992) Arthroscopic partial meniscectomy: a long-term follow-up. Arthrosc J Arthrosc Relat Surg 8(3):345–349CrossRefGoogle Scholar
  12. 12.
    Athanasiou KA, Sanchez-Adams J (2009) Engineering the knee meniscus. Morgan Claypool Publishers, Rice University, USACrossRefGoogle Scholar
  13. 13.
    Weiss E (2014) Knee osteoarthritis, body mass index and pain: data from the osteoarthritis initiative. Rheumatology 53(11):2095–2099CrossRefGoogle Scholar
  14. 14.
    Maffulli N, Longo UG, Campi S, Denaro V (2010) Meniscal tears. Open access J Sports Med 1:45CrossRefGoogle Scholar
  15. 15.
    Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF (1988) Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med 109(1):18–24CrossRefGoogle Scholar
  16. 16.
    Loeser RF, Collins JA, Diekman BO (2016) Ageing and the pathogenesis of osteoarthritis. Nat Rev Rheumatol 12(7):412CrossRefGoogle Scholar
  17. 17.
    Mesiha M, Zurakowski D, Soriano J, Nielson JH, Zarins B, Murray MM (2007) Pathologic characteristics of the torn human meniscus. Am J Sports Med 35(1):103–112CrossRefGoogle Scholar
  18. 18.
    Loeser RF (2010) Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med 26(3):371–386CrossRefGoogle Scholar
  19. 19.
    Chia HN, Hull ML (2008) Compressive moduli of the human medial meniscus in the axial and radial directions at equilibrium and at a physiological strain rate. J Orthop Res 26(7):951–956CrossRefGoogle Scholar
  20. 20.
    Janarthanan G, Pillai MM, Kulasekaran SS, Rajendran S, Bhattacharyya A (2019) Engineered knee meniscus construct: understanding the structure and impact of functionalization in 3D environment. Polym Bull.  https://doi.org/10.1007/s00289-019-02874-0 Google Scholar
  21. 21.
    Gopinathan J, Pillai MM, Shanthakumari S, Gnanapoongothai S, Rai BKD, Sahanand KS, Bhattacharyya A (2018) Carbon nanofiber amalgamated 3D poly-ε-caprolactone scaffold functionalized porous-nanoarchitectures for human meniscal tissue engineering: in vitro and in vivo biocompatibility studies. Nanomed Nanotechnol Biol Med 14(7):2247–2258CrossRefGoogle Scholar
  22. 22.
    Pillai MM, Gopinathan J, Senthil Kumar R, Sathish Kumar G, Shanthakumari S, Sahanand KS, Selvakumar R (2018) Tissue engineering of human knee meniscus using functionalized and reinforced silk-polyvinyl alcohol composite three-dimensional scaffolds: understanding the in vitro and in vivo behavior. J Biomed Mater Res Part A 106(6):1722–1731CrossRefGoogle Scholar
  23. 23.
    Guo H, Maher SA, Spilker RL (2013) Biphasic finite element contact analysis of the knee joint using an augmented Lagrangian method. Med Eng Phys 35(9):1313–1320CrossRefGoogle Scholar
  24. 24.
    Pena E, Calvo B, Martinez MA, Palanca D, Doblaré M (2006) Why lateral meniscectomy is more dangerous than medial meniscectomy. a finite element study. J Orthop Res 24(5):1001–1010CrossRefGoogle Scholar

Copyright information

© Indian Institute of Science 2019

Authors and Affiliations

  1. 1.Tissue Engineering LaboratoryPSG Institute of Advanced StudiesCoimbatoreIndia
  2. 2.Functional, Innovative and Smart TextilesPSG Institute of Advanced StudiesCoimbatoreIndia
  3. 3.Orthopaedic DepartmentGanga Hospital CoimbatoreCoimbatoreIndia
  4. 4.Ortho One Orthopaedic Speciality CentreCoimbatoreIndia

Personalised recommendations