The amount of resected tissue is the main predictor of the onset of osteoarthritis after meniscectomy, thereby increasing the risk for patients who have total meniscectomy.1,2 Consequently, approximately 50% of patients who have total or subtotal meniscectomy develop symptomatic osteoarthritis.1,2 Allografts have been shown to successfully reduce pain and improve knee function in patients with total or subtotal meniscectomy.3 However, strict size-matching criteria limit graft availability, and after implantation, shrinkage and re-tearing of allografts are frequently observed.3 Moreover, meniscal allograft transplantation is generally restricted to patients younger than 50 years, while most meniscectomies are performed in patients over 45 years.4 An implant that is able to obviate these limitations may serve as an alternative to meniscal allografts.
Trammpolin® meniscus prosthesis is an anatomically shaped, solid, nondegradable, polymer implant designed to mimic the function of the native meniscus. The Trammpolin® material is capable of maintaining a fluid film between 2 bearing surfaces, thereby providing a mechanism for lubrication of synovial joints. The Trammpolin® meniscus prosthesis can provide full functionality from the moment of implantation and therefore is a potential solution.5,6,7
Biomechanical models, computer simulations and in-vivo experiments showed similar biomechanical performance as a meniscal allograft for evaluations of tibial contact mechanics, meniscal kinematics, and knee laxity.8
1. Englund M, Lohmander LS. Risk factors for symptomatic knee oste- oarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum. 2004;50(9):2811-2819
2. Hede A, Larsen E, Sandberg H. The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop. 1992;16(2):122-125
3. Hommen JP, Applegate GR, Del Pizzo W. Meniscus allograft trans- plantation: ten-year results of cryopreserved allografts. Arthroscopy. 2007;23(4):388-393.
4. Abrams GD, Frank RM, Gupta AK, Harris JD, McCormick FM, Cole BJ. Trends in meniscus repair and meniscectomy in the United States, 2005-2011. Am J Sports Med. 2013;41(10):2333-2339.
5. Carbone A, Howie DW, McGee M, et al. Aging performance of a com- pliant layer bearing acetabular prosthesis in an ovine hip arthroplasty model. J Arthroplasty. 2006;21(6):899-906.
6. Flanagan S. Friction, Lubrication and Wear of Total Joint Replacements [PhD dissertation]. Limerick, Republic of Ireland: Faculty of Science & Engineering University of Limerick; 2010.
7. Khan I, Smith N, Jones E, Finch DS, Cameron RE. Analysis and eval- uation of a biomedical polycarbonate urethane tested in an in vitro study and an ovine arthroplasty model, part II: in vivo investigation. Biomaterials. 2005;26(6):633-643.
8. Vrancken AC, Eggermont F, van Tienen TG, et al. Functional biome- chanical performance of a novel anatomically shaped polycarbonate urethane total meniscus replacement. Knee Surg Sports Traumatol Arthrosc. 2016;24(5):1485-1494.
Vrancken ACT, Hannink G, Madej W, Verdonschot N, van Tienen TG, Buma P.In Vivo Performance of a Novel, Anatomically Shaped, Total Meniscal Prosthesis Made of Polycarbonate Urethane: A 12-Month Evaluation in Goats. Am J Sports Med. 2017 Oct;45(12):2824-2834.
Vrancken ACT, Eggermont F, van Tienen TG , Hannink G, Buma P, Janssen D, Verdonschot N; Functional biomechanical performance of a novel anatomically shaped polycarbonate urethane total meniscus replacement; Knee Surgery, Sports Traumatology, Arthroscopy (2016), 24:1485-1494
Khoshgoftar M, Vrancken ACT, Janssen D, van Tienen TG , Buma P, Verdonschot N; The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant; Journal of Biomechanics (2015), 48(8):1427-1435
Vrancken ACT, Madej W, Hannink G, Verdonschot N, van Tienen TG, Buma P; Short term evaluation of an anatomically shaped polycarbonate urethane total meniscus replacement in a goat model; PloS One (2015), 10(7):e0133138
Vrancken ACT, Crijns SPM, Ploegmakers MJ, O’Kane C, van Tienen TG , Janssen D, Buma P, Verdonschot N; 3D geometry analysis of the medial meniscus – a statistical shape modelling approach; Journal of Anatomy (2014), 225(4):395-402
Vrancken ACT, van Tienen TG , Hannink G, Janssen D, Verdonschot N, Buma P; Releasing the circumferential fixation of the medial meniscus does not influence its kinematics; The Knee (2014), 21:1033-1038