Abstract
Introduction: The realisation that the medical and lateral menisci of the knee have important load-bearing and stability functions has stimulated orthopaedic surgeons to aim for preservation rather than excision if at all possible. The absence of meniscal tissue has been shown to increase load through the articular cartilage and ultimately accelerate the process of osteoarthritic degeneration. A major limitation is the relative avascularity of a large portion of the normal meniscus. McAndrews and Arnoczky reported in 1996 that repair of the white-white and even red-white zone remains a challenge. Monobutyrin is an angiogenic factor that has been used in the stimulation of healing burns and we hypothesized that it may have a positive effect on the healing meniscus.
The aim of the study was to determine the effects of 0 Ticron suture soaked in polyhydroxybutyrate (PHB) on the histological and mechanical properties of healing meniscal tears in the red-white zone in an established animal model.
Methods: A bilateral medical meniscal incision model was used in 21 adult sheep.
Results: We confirmed that the PHB had no deleterious effects on the mechanical properties of the suture prior to commencing the surgery. Mechanical testing of the menisci at the set time-points demonstrated a significantly stronger repair in the PHB-soaked group. Macroscopic appearances were graded and found to be improved with PHB soaked sutures. On histological examination there were features suggestive of a more intense healing response including angiogenesis.
Conclusions: We have concluded that the use of butyric acid has no deleterious effects on the mechanical properties of the suture used and has positive effects on meniscal healing. We recommend further examination of this exciting development.
The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
