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Experimental study on thermal welding for the knee meniscal white zone
Naoaki Imakiire1, Akihiro Kotani, Yoshiaki Ishii
1Department of Orthopaedic Surgery, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka 181-8611, Japan.
Summary
Optimal thermal welding at 63°C shows promise for repairing human meniscus white zone tears. This temperature preserves cell structures, unlike higher temperatures, suggesting a feasible surgical approach for meniscal repair.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Regenerative Medicine
Background:
- Meniscal white zone tears are challenging to repair surgically.
- Suturing techniques have limitations in the avascular white zone.
- Thermal welding presents a potential alternative for meniscal tissue repair.
Purpose of the Study:
- To determine the optimal temperature for thermal welding of the human meniscus white zone.
- To evaluate the efficacy of thermal welding in repairing meniscal tears.
- To assess the biomechanical and histological outcomes of thermal welding at different temperatures.
Main Methods:
- Thermal welding experiments were conducted on bovine and human menisci.
- Tensile strength, histological findings (including TEM), and biochemical analyses were performed.
- Human meniscal white zone welding was tested at 63°C and 69°C, based on bovine results.
Main Results:
- The highest tensile strength achieved was 101.4 ± 2.6 g/cm² at 63°C in human menisci.
- Cell nuclei structure was preserved at 63°C, but denaturation and necrosis occurred at 69°C.
- Pyridinoline levels, a collagen cross-linking marker, tended to decrease with increasing welding temperature.
Conclusions:
- Thermal welding at 63°C appears feasible for repairing human meniscal white zone tears.
- This temperature optimizes tensile strength while preserving cellular integrity for regeneration.
- Further research may validate thermal welding as a viable clinical treatment for meniscal injuries.