Active Implants LLC, 6060 Primacy Parkway, Suite 460, Memphis, TN, 38119, USA.
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, 6997801, Tel Aviv, Israel.
Biomech Model Mechanobiol. 2020 Dec;19(6):2049-2059. doi: 10.1007/s10237-020-01323-6. Epub 2020 Mar 31.
The altered biomechanical function of the knee following partial meniscectomy results in ongoing articular cartilage overload, which may lead to progressive osteoarthritis (OA). An artificial medial meniscus implant (NUsurface Meniscus Implant, Active Implants LLC., Memphis, TN, USA) was developed to mimic the native meniscus and may provide an effective long-term solution for OA patients, alleviate pain, and restore joint function. The goal of the current study was to investigate the potential effect of an artificial medial meniscus implant on the function of the lateral compartment of the knee and on the potential alterations in load distribution between the two compartments under static axial loading, using advanced piezo-resistive sensors. We used an integrated in situ/in vivo experimental approach combining contact pressure measurements of cadaveric knees with MRI joint space measurements of 72 mild OA patients. We employed this integrated approach to evaluate the mechanical consequences in both the medial (treated) and lateral knee compartments of two levels of meniscectomy and implantation of an artificial meniscus implant. Partial and subtotal meniscectomies of the medial meniscus resulted in statistically significant decrease in contact areas (p = 0.008 and p < 0.0001, respectively) and increased contact pressures in the medial compartment; however, implantation of the artificial meniscus implant restored the average contact pressure to 93 ± 14% of its pre-meniscectomy, intact value. Additionally, we found that neither the two different grades of medial meniscectomies, nor implantation of the artificial medial meniscus implant affected the lateral compartment of the knee. The MRI data from the patient cohort facilitated the integration of real-life clinical results together with the laboratory measurements from our cadaveric study, as these two approaches complement each other. We conclude that the use of the artificial medial meniscus implant may re-establish normal load distribution across the articulating surfaces of the medial compartment and not increase loading across the lateral knee compartment.
膝关节部分半月板切除术后，生物力学功能发生改变，导致持续的关节软骨超负荷，可能导致进行性骨关节炎（OA）。开发了一种人工内侧半月板植入物（NUsurface 半月板植入物，Active Implants LLC.，孟菲斯，TN，美国），以模拟天然半月板，并可能为 OA 患者提供有效的长期解决方案，减轻疼痛并恢复关节功能。本研究的目的是使用先进的压阻传感器研究人工内侧半月板植入物对膝关节外侧间室功能的潜在影响，以及在静态轴向加载下两个间室之间负荷分布的潜在变化。我们采用了一种综合的原位/体内实验方法，结合尸体膝关节的接触压力测量和 72 例轻度 OA 患者的 MRI 关节间隙测量。我们采用这种综合方法来评估内侧（治疗）和外侧膝关节间室在两种半月板切除和人工半月板植入水平下的力学后果。内侧半月板的部分和次全切除术导致内侧间室的接触面积显著减少（p=0.008 和 p<0.0001），接触压力增加；然而，人工半月板植入物的植入恢复了平均接触压力，达到术前内侧完整半月板的 93±14%。此外，我们发现两种不同程度的内侧半月板切除术，以及人工内侧半月板植入物的植入均不会影响膝关节的外侧间室。患者队列的 MRI 数据促进了真实临床结果与我们尸体研究的实验室测量结果的整合，因为这两种方法相互补充。我们得出结论，人工内侧半月板植入物的使用可能会重新建立内侧间室关节表面的正常负荷分布，而不会增加外侧膝关节间室的负荷。
