Augmented meniscal healing with free synovial autografts: an organ culture model

We examined whether or not free synovial autografts can augment the healing of lesions artificially created in the human knee meniscus in an organ culture model. The effectiveness of free synovial autografts was also compared with that of fibrin glue (Tisseel). In the control group, the accumulation of cellular components increased at the edge of a 4-mm meniscal defect following culture, although no cells were found to invade the defect. In the fibrin glue group, an increased migration of cells into fibrin glue packed into the defect was observed until 4 weeks following cultivation. However, newly formed collagen produced by the cells in the fibrin glue was minimal even 4 weeks after cultivation. In contrast, in the synovial group, newly formed collagen production, as well as cellular proliferation, increased in the grafted synovium with time after cultivation. By 4 weeks, the gap between the edge of the defect and the grafted synovium was bridged by newly formed collagen tissue, indicating improved histologic repair. Our results suggest that free autogenous synovial tissue grafts in meniscal lesions are superior to fibrin glue, and that interpositional synovial autografts to augment repair of meniscal tears in the avascular zone may be clinically useful.