Skip to main content

Meniscal Augmentation and Replacement (Menaflex, Actifit, and NUsurface)

  • Chapter
  • First Online:
Book cover Cartilage Restoration

Abstract

In the last decades, the surgical treatment of meniscal injury or damage has shifted from a total meniscectomy to a partial meniscectomy or repair. Rather than a removal of meniscal tissue, the goal of novel surgical techniques is to preserve as much functional meniscal tissue as possible. Recently, attempts have been made to promote meniscal healing, as well as the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. This chapter will focus on meniscal augmentation and on three types of meniscal replacement devices. These substitutes are the biological Menaflex™ or collagen meniscal implant (CMI), the biomimetic Actifit™ meniscal scaffold, and the nonbiological NUsurface® meniscal substitute.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med. 1982;10:90–5.

    Article  CAS  PubMed  Google Scholar 

  2. Maak TG, Fabricant PD, Wickiewicz TL. Indications for meniscus repair. Clin Sports Med. 2012;31:1–14.

    Article  PubMed  Google Scholar 

  3. Moran CJ, Busilacchi A, Lee CA, Athanasiou KA, Verdonk PC. Biological augmentation and tissue engineering approaches in meniscus surgery. Arthroscopy. 2015;31:944–55.

    Article  PubMed  Google Scholar 

  4. Scotti C, Hirschmann MT, Antinolfi P, Martin I, Peretti GM. Meniscus repair and regeneration: review on current methods and research potential. Eur Cell Mater. 2013;26:150–70.

    Article  CAS  PubMed  Google Scholar 

  5. Jang SH, Ha JK, Lee DW, Kim JG. Fibrin clot delivery system for meniscal repair. Knee Surg Relat Res. 2011;23:180–3.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ra HJ, Ha JK, Jang SH, Lee DW, Kim JG. Arthroscopic inside-out repair of complete radial tears of the meniscus with a fibrin clot. Knee Surg Sports Traumatol Arthrosc. 2013;21:2126–30.

    Article  PubMed  Google Scholar 

  7. Vangsness CT Jr, Farr J II, Boyd J, Dellaero DT, Mills CR, Leroux-Williams M. Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014;96:90–8.

    Article  PubMed  Google Scholar 

  8. Stone KR, Rodkey WG, Webber R, et al. Meniscal regeneration with co polymeric collagen scaffolds. In vitro and in vivo studies evaluated clinically, histologically, and biochemically. Am J Sports Med. 1992;20:104–11.

    Article  CAS  PubMed  Google Scholar 

  9. Rodkey WG, Steadman JR, Li ST. A clinical study of collagen meniscus implants to restore the injured meniscus. Clin Orthop Relat Res. 1999;367:281–92.

    Article  Google Scholar 

  10. Stone KR, Steadman JR, Rodkey WG, et al. Regeneration of meniscal cartilage with use of a collagen scaffold. Analysis of preliminary data. J Bone Joint Surg Am. 1997;79:1770–7.

    Article  CAS  PubMed  Google Scholar 

  11. Zaffagnini S, Marcheggiani Muccioli GM, Lopomo N, et al. Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy: a minimum 10-year follow-up study. Am J Sports Med. 2011;39:977–85.

    Article  PubMed  Google Scholar 

  12. Tienen TG, Heijkants RG, de GJH, et al. Replacement of the knee meniscus by a porous polymer implant: a study in dogs. Am J Sports Med. 2006;34:64–71.

    Article  PubMed  Google Scholar 

  13. Verdonk P, Verdonk R, Huysse W, et al. Successful treatment of painful irreparable partial meniscal defects with a polyurethane scaffold—two year safety and clinical outcomes. Am J Sports Med. 2012;40:844–53.

    Article  PubMed  Google Scholar 

  14. Verdonk R, Verdonk P, Huysse W, et al. Tissue ingrowth after implantation of a novel, biodegradable polyurethane scaffold for treatment of partial meniscal lesions. Am J Sports Med. 2011;39:774–82.

    Article  PubMed  Google Scholar 

  15. Dhollander A, Verdonk P, Verdonk R. Treatment of painful, irreparable partial meniscal defects with a polyurethane scaffold: midterm clinical outcomes and survival analysis. Am J Sports Med. 2016;44:2615–21.

    Article  PubMed  Google Scholar 

  16. Zorzi C, Condello V, Verdonk P, et al. Too old for regenerative treatment? Too young for joint replacement? Clinical indication for a novel meniscus implant. ICRS 2012 meeting, Montreal, Canada, 12–15 May 2012.

    Google Scholar 

  17. Elsner JJ, Portnoy S, Guilak F, Shterling A, Linder-Ganz E. MRI-based characterization of bone anatomy in the human knee for size matching of a medialmeniscal implant. J Biomech Eng. 2010;132:101008.

    Article  PubMed  Google Scholar 

  18. Linder-Ganz E, Elsner JJ, Danino A, Guilak F, Shterling A. A novel quantitative approach for evaluating contact mechanics of meniscal replacements. J Biomech Eng. 2010;132:024501.

    Article  CAS  PubMed  Google Scholar 

  19. Elsner JJ, Shemesh M, Shefy-Peleg A, Gabet Y, Zylberberg E, Linder-Ganz E. Quantification of in vitro wear of a synthetic meniscus implant using gravimetric and micro-CT measurements. J Mech Behav Biomed Mater. 2015;49:310–20.

    Article  CAS  PubMed  Google Scholar 

  20. Elsner JJ, Portnoy S, Zur G, Guilak F, Shterling A, Linder-Ganz E. Design of a free-floating polycarbonate-urethane meniscal implant using finite element modeling and experimental validation. J Biomech Eng. 2010;132:095001.

    Article  PubMed  Google Scholar 

  21. Zur G, Linder-Ganz E, Elsner JJ, Shani J, Brenner O, Agar G, Hershman EB, Arnoczky SP, Guilak F, Shterling A. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg Sports Traumatol Arthrosc. 2011;19:255–63.

    Article  PubMed  Google Scholar 

  22. Shemesh M, Asher R, Zylberberg E, Guilak F, Linder-Ganz E, Elsner JJ. Viscoelastic properties of a synthetic meniscus implant. J Mech Behav Biomed Mater. 2014;29:42–55.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vincenzo Condello .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dhollander, A.A.M., Condello, V., Madonna, V., Bonomo, M., Verdonk, P. (2018). Meniscal Augmentation and Replacement (Menaflex, Actifit, and NUsurface). In: Farr, J., Gomoll, A. (eds) Cartilage Restoration. Springer, Cham. https://doi.org/10.1007/978-3-319-77152-6_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77152-6_28

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77151-9

  • Online ISBN: 978-3-319-77152-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics