Knee surgery: an artificial meniscus brings back the clock after the injury

A European project coordinated by Humanitas is studying new solutions for patients whose meniscus has been removed following an injury. It is a very widespread condition that, over time, can create discomfort and pain. The experimentation, as part of Horizon 2020, has started on an artificial meniscus made of modern bio-materials: “a meniscus which is able to integrate with the joint” says Prof. Elizaveta Kon, Associate Professor of Diseases of the Musculoskeletal System at Humanitas University, and Head of the Orthopedics Section.

Meniscal reconstruction is a widespread clinical need and a condition that affects many patients

It is a very common problem. Many patients have had their meniscus removed. It is one of the most common surgery of the knee worldwide. For decades, the meniscus was treated a bit like the appendix: it was just took off. But the meniscus is the shock absorber of the knee, it is not useless, quite the contrary. If you lose it, you can have difficulties. It is a condition that has been studied for some time.

What are the long-term consequences of removing the meniscus?

The world is beginning to understand that removing a person’s meniscus is not without consequences. The greater the percentage of the meniscus lost, the more you risk having pain when you walk, especially in the long term. Today alternative solutions to removal are sought, but it is not always possible.

What is the goal of your project?

The project aims to recreate an artificial meniscus. A new meniscus is implanted to the patient, a meniscus made with new-generation bio-materials, biologically active and facilitate tissue regeneration. We work on developing the ability to regenerate blood vessels and tissues, so that the new material becomes part of the joint. This is the first part of the project, which mainly concerns people who have undergone the surgery recently.

What solutions are being studied for other patients?

For patients who have lost their meniscus a long time ago, or people who have developed arthrosis, the solution is to implant a meniscal prosthesis, which also acts as a deposit for anti-inflammatory factors. It isn’t just a mechanical bearing.

Is part of the project also about prevention?

Yes. The third strand of the project aims to understand which patients are at risk. We now know that a particular knee morphology is linked to patients who are more likely to develop problems after meniscus loss. A large-scale clinical study is currently underway. The purpose is to understand what these factors are, so that, when a patient comes with a broken meniscus, the doctor can decide, based on the level of risk, if it is better not to remove it and therefore seek other solutions.

Can the artificial meniscus you are studying also be implanted for athletes and sportsmen?

As mentioned, the first line of study, concerning the vascularized meniscus implant, is dedicated to young people. It is an intervention that allows the return to the previous life. In fact it actually brings back the clock. The second strand will presumably be dedicated to older people. We always consider active patients, who want to continue physical activity and to live normal life. Today the population is aging and people don’t give up activities.

At what point is the study? Will it also involve Hunimed students?

We are still in the pre-clinical trial phase. The project lasts five years and we know that research takes time. Student’s involvement is always important to us. I am very keen on helping young doctors grow as thinking professionals, who know how to take an opportunities to have an active role in research.