Personalized Fiber-Reinforcement Networks for Meniscus Reconstruction

Jay M. Patel; Andrzej Brzezinski; Salim A. Ghodbane; Rae Tarapore; Tyler M. Lu; Charles J. Gatt; Michael G. Dunn

doi:https://doi.org/10.1115/1.4045402

Personalized Fiber-Reinforcement Networks for Meniscus Reconstruction

Jay M. Patel, Andrzej Brzezinski, Salim A. Ghodbane, Rae Tarapore, Tyler M. Lu, Charles J. Gatt, Michael G. Dunn

Robert Wood Johnson Medical School (RWJMS), Orthopedic Surgery

Rutgers, The State University

Research output: Contribution to journal › Article › peer-review

Abstract

The menisci are fibrocartilaginous tissues that are crucial to the load-sharing and stability of the knee, and when injured, these properties are compromised. Meniscus replacement scaffolds have utilized the circumferential alignment of fibers to recapitulate the microstructure of the native meniscus; however, specific consideration of size, shape, and morphology has been largely overlooked. The purpose of this study was to personalize the fiber-reinforcement network of a meniscus reconstruction scaffold. Human cadaveric menisci were measured for a host of tissue (length, width) and subtissue (regional widths, root locations) properties, which all showed considerable variability between donors. Next, the asymmetrical fiber network was optimized to minimize the error between the dimensions of measured menisci and predicted fiber networks, providing a 51.0% decrease (p = 0.0091) in root-mean-square (RMS) error. Finally, a separate set of human cadaveric knees was obtained, and donor-specific fiber-reinforced scaffolds were fabricated. Under cyclic loading for load-distribution analysis, in situ implantation of personalized scaffolds following total meniscectomy restored contact area (253.0 mm2 to 488.9 mm2, p = 0.0060) and decreased contact stress (1.96 MPa to 1.03 MPa, p = 0.0025) to near-native values (597.4 mm2 and 0.83 MPa). Clinical use of personalized meniscus devices that restore physiologic contact stress distributions may prevent the development of post-traumatic osteoarthritis following meniscal injury.

Original language	American English
Article number	051008 EN
Journal	Journal of Biomechanical Engineering
Volume	142
Issue number	5
DOIs	https://doi.org/10.1115/1.4045402
State	Published - May 1 2020

ASJC Scopus subject areas

Biomedical Engineering
Physiology (medical)

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https://doi.org/10.1115/1.4045402

Cite this

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title = "Personalized Fiber-Reinforcement Networks for Meniscus Reconstruction",

abstract = "The menisci are fibrocartilaginous tissues that are crucial to the load-sharing and stability of the knee, and when injured, these properties are compromised. Meniscus replacement scaffolds have utilized the circumferential alignment of fibers to recapitulate the microstructure of the native meniscus; however, specific consideration of size, shape, and morphology has been largely overlooked. The purpose of this study was to personalize the fiber-reinforcement network of a meniscus reconstruction scaffold. Human cadaveric menisci were measured for a host of tissue (length, width) and subtissue (regional widths, root locations) properties, which all showed considerable variability between donors. Next, the asymmetrical fiber network was optimized to minimize the error between the dimensions of measured menisci and predicted fiber networks, providing a 51.0% decrease (p = 0.0091) in root-mean-square (RMS) error. Finally, a separate set of human cadaveric knees was obtained, and donor-specific fiber-reinforced scaffolds were fabricated. Under cyclic loading for load-distribution analysis, in situ implantation of personalized scaffolds following total meniscectomy restored contact area (253.0 mm2 to 488.9 mm2, p = 0.0060) and decreased contact stress (1.96 MPa to 1.03 MPa, p = 0.0025) to near-native values (597.4 mm2 and 0.83 MPa). Clinical use of personalized meniscus devices that restore physiologic contact stress distributions may prevent the development of post-traumatic osteoarthritis following meniscal injury.",

author = "Patel, {Jay M.} and Andrzej Brzezinski and Ghodbane, {Salim A.} and Rae Tarapore and Lu, {Tyler M.} and Gatt, {Charles J.} and Dunn, {Michael G.}",

note = "Funding Information: We thank the staff of the Department of Orthopedic Surgery at Rutgers Biomedical and Health Sciences, and specifically Barbara Perry, for their help with cadaver specimen handling and disposal. We thank the Musculoskeletal Transplant Foundation (MTF Biologics) for the donation of human cadaveric menisci. We thank Dr. Joachim Kohn and Dr. Sanjeeva Murthy (NJ Center for Biomaterials, Department of Chemistry, Rutgers University) for synthesizing the polymer and drawing the monofilament fiber. We would like to acknowledge William Schneider (Department of Physics and Astronomy, Rutgers University) for his assistance in designing and building the custom Instron jig. The research herein was funded in part, by NovoPedics, Inc., and the Orthopaedic Surgery discretionary fund. The meniscus device described in this paper has three issued patents (U.S. 8,623,085; U.S. 9,078,756 B2; U.S. 9,579,212 B2) and two patents pending. The technology has been licensed for product development (MeniscoFix, NovoPedics, Inc.). J. M. P. serves as a consultant for NovoPedics. C. J. G. serves as interim president and owns stock in NovoPedics. Publisher Copyright: {\textcopyright} 2020 American Society of Mechanical Engineers (ASME). All rights reserved.",

year = "2020",

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doi = "https://doi.org/10.1115/1.4045402",

language = "American English",

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AU - Patel, Jay M.

AU - Brzezinski, Andrzej

AU - Ghodbane, Salim A.

AU - Tarapore, Rae

AU - Lu, Tyler M.

AU - Gatt, Charles J.

AU - Dunn, Michael G.

N1 - Funding Information: We thank the staff of the Department of Orthopedic Surgery at Rutgers Biomedical and Health Sciences, and specifically Barbara Perry, for their help with cadaver specimen handling and disposal. We thank the Musculoskeletal Transplant Foundation (MTF Biologics) for the donation of human cadaveric menisci. We thank Dr. Joachim Kohn and Dr. Sanjeeva Murthy (NJ Center for Biomaterials, Department of Chemistry, Rutgers University) for synthesizing the polymer and drawing the monofilament fiber. We would like to acknowledge William Schneider (Department of Physics and Astronomy, Rutgers University) for his assistance in designing and building the custom Instron jig. The research herein was funded in part, by NovoPedics, Inc., and the Orthopaedic Surgery discretionary fund. The meniscus device described in this paper has three issued patents (U.S. 8,623,085; U.S. 9,078,756 B2; U.S. 9,579,212 B2) and two patents pending. The technology has been licensed for product development (MeniscoFix, NovoPedics, Inc.). J. M. P. serves as a consultant for NovoPedics. C. J. G. serves as interim president and owns stock in NovoPedics. Publisher Copyright: © 2020 American Society of Mechanical Engineers (ASME). All rights reserved.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - The menisci are fibrocartilaginous tissues that are crucial to the load-sharing and stability of the knee, and when injured, these properties are compromised. Meniscus replacement scaffolds have utilized the circumferential alignment of fibers to recapitulate the microstructure of the native meniscus; however, specific consideration of size, shape, and morphology has been largely overlooked. The purpose of this study was to personalize the fiber-reinforcement network of a meniscus reconstruction scaffold. Human cadaveric menisci were measured for a host of tissue (length, width) and subtissue (regional widths, root locations) properties, which all showed considerable variability between donors. Next, the asymmetrical fiber network was optimized to minimize the error between the dimensions of measured menisci and predicted fiber networks, providing a 51.0% decrease (p = 0.0091) in root-mean-square (RMS) error. Finally, a separate set of human cadaveric knees was obtained, and donor-specific fiber-reinforced scaffolds were fabricated. Under cyclic loading for load-distribution analysis, in situ implantation of personalized scaffolds following total meniscectomy restored contact area (253.0 mm2 to 488.9 mm2, p = 0.0060) and decreased contact stress (1.96 MPa to 1.03 MPa, p = 0.0025) to near-native values (597.4 mm2 and 0.83 MPa). Clinical use of personalized meniscus devices that restore physiologic contact stress distributions may prevent the development of post-traumatic osteoarthritis following meniscal injury.

AB - The menisci are fibrocartilaginous tissues that are crucial to the load-sharing and stability of the knee, and when injured, these properties are compromised. Meniscus replacement scaffolds have utilized the circumferential alignment of fibers to recapitulate the microstructure of the native meniscus; however, specific consideration of size, shape, and morphology has been largely overlooked. The purpose of this study was to personalize the fiber-reinforcement network of a meniscus reconstruction scaffold. Human cadaveric menisci were measured for a host of tissue (length, width) and subtissue (regional widths, root locations) properties, which all showed considerable variability between donors. Next, the asymmetrical fiber network was optimized to minimize the error between the dimensions of measured menisci and predicted fiber networks, providing a 51.0% decrease (p = 0.0091) in root-mean-square (RMS) error. Finally, a separate set of human cadaveric knees was obtained, and donor-specific fiber-reinforced scaffolds were fabricated. Under cyclic loading for load-distribution analysis, in situ implantation of personalized scaffolds following total meniscectomy restored contact area (253.0 mm2 to 488.9 mm2, p = 0.0060) and decreased contact stress (1.96 MPa to 1.03 MPa, p = 0.0025) to near-native values (597.4 mm2 and 0.83 MPa). Clinical use of personalized meniscus devices that restore physiologic contact stress distributions may prevent the development of post-traumatic osteoarthritis following meniscal injury.

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Personalized Fiber-Reinforcement Networks for Meniscus Reconstruction

Abstract

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