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Free synovium promotes meniscal healing. Synovium, muscle and synthetic mesh compared in dogs
K Shirakura1, M Niijima, Y Kobuna
1Department of Orthopaedic Surgery, Gunma University School of Medicine, Japan.
Abstract:
We studied the effect of free synovium on the healing of tears in the avascular portion of the menisci in dogs. A longitudinal incision was made in the medial meniscus. In 35 dogs, a free graft of synovium was inserted into the tear and sutured. In 10 dogs, a free graft of quadriceps muscle was used. In 10 dogs, a Dacron mesh was inserted. In the contralateral knee, the tear was sutured without implantation as a control. 2, 4, 6, 8, and 12 weeks after the operation, the menisci were dissected. 11 of the 35 with free synovium were healed. The menisci with muscle grafts, those with Dacron mesh and those in the control group did not heal. Histology showed that tears were repaired with fibrous tissue. Microangiography showed that capillaries grew from the periphery, but they did not reach the tear.
Insights
Free synovium grafts showed potential for healing meniscus tears in dogs, unlike muscle grafts or Dacron mesh. Further research is needed to improve vascularization for complete meniscal repair.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Veterinary Science
Background:
- Meniscal tears, particularly in the avascular zone, have limited healing capacity due to poor blood supply.
- Current treatments for avascular meniscal tears often involve partial meniscectomy, which can lead to long-term joint issues.
- Investigating novel graft materials to enhance meniscal healing is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of free synovium grafts in promoting the healing of surgically created meniscal tears in the avascular zone of canine knees.
- To compare the healing response of synovium grafts with other implant materials, including quadriceps muscle grafts and Dacron mesh, as well as a control group.
Main Methods:
- Longitudinal incisions were created in the medial meniscus of canine knees.
- Grafts of free synovium, quadriceps muscle, or Dacron mesh were implanted into the tears and sutured.
- Control knees had tears sutured without any graft implantation.
- Menisci were analyzed at 2, 4, 6, 8, and 12 weeks post-operation via dissection, histology, and microangiography.
Main Results:
- Eleven out of 35 dogs treated with free synovium grafts demonstrated healed meniscal tears.
- Menisci treated with muscle grafts, Dacron mesh, or no graft (control) did not heal.
- Histological examination revealed repair with fibrous tissue in all groups.
- Microangiography indicated capillary growth from the periphery, but these vessels did not extend into the grafted tear site.
Conclusions:
- Free synovium grafts show promise in promoting healing of avascular meniscal tears in dogs, although healing was not complete in all cases.
- Muscle grafts and Dacron mesh were ineffective in promoting meniscal healing.
- The limited vascularization of the grafted area remains a challenge for achieving complete meniscal regeneration.