Tissue-engineered Meniscal Replacement in Dogs Using Small Intestinal Submucosa: Phase 2, Addition of Autogenous Fibrin Clot and Biomechanical Protection

Introduction Meniscal injuries in human and veterinary patients result in a significant loss of function, and those occurring in the avascular zone of the meniscus will not heal spontaneously. Although most meniscal injuries are currently treated by partial meniscectomy, most research is now focused on methods for producing functional tissue in avascular meniscal defects. We have previously demonstrated the ability to induce meniscal-like tissue regeneration in large, avascular meniscal defects using porcine small intestinal submucosa (SIS). While the results of our previous work have been encouraging, complete regeneration of the meniscus with total protection of articular cartilage has not been realized in large (80%), avascular defects. Early biomechanical disruption of regenerating tissue has been proposed as a primary detriment to achieving complete regeneration. The purpose of this study was to determine the effects of biomechanical protection and fibrin clot augmentation on meniscal tissue-engineering using SIS grafts in dogs.