Building a Better Meniscus

Researchers at UQ's AIBN are developing an artificial meniscus to replace damaged knee cartilage.

The meniscus is the knee's shock absorber. It is a cartilage spacer found between the thigh and shin bones, preventing friction and absorbing approximately one third of the impact load that the joint cartilage surface experiences.

AIBN's Associate Professor Justin Cooper-White heads the project, which is supported by UQ's Faculty of Health Sciences and the Mater Medical Research Institute, and also capitalises on the cell biology expertise of AIBN's Professor Julie Campbell.

In the latest round of Australian Research Council Discovery Projects announced recently, Professor Campbell was awarded $430,000 to develop a meniscal implant to benefit the millions of people annually affected by meniscus damage or loss.

The project aims to develop a tissue-engineered meniscus using tailored three-dimensional scaffolds and mesenchymal stem cells (precursors of the meniscus).

"Elite athletes are not the only people who suffer meniscal damage," Dr Cooper-White said.

"The general wear and tear of normal life can cause damage requiring surgery.

"In fact, in any gathering of people, about 50 percent of the group will have a damaged meniscus and some may not have any meniscus in one or both of their knees.

"Unlike other body tissues, the meniscus does not repair itself because only a very small part receives blood, which is why surgery is often needed.

"While most patients quickly recover from a meniscusectomy, long-term issues such as early arthritis of the knee joint are common."

Dr Cooper-White said the project had two parts. The first was to produce viable structural and functional scaffolds capable of promoting the growth of mesenchymal stem cells, and differentiate these cells into meniscal tissue using a specially designed bioreactor.

Secondly, the team would investigate the way these structures, laden with mesenchymal stem cells, could be incorporated into the body.

"The holy grail would be to harvest some mesenchymal stem cells from the patient, combine them with the scaffolds and appropriate growth factors and then insert this matrix into the knee so the patient effectively regrows their meniscus," he said.

"Alternatively, we are attempting to create an artificial environment mimicking as closely as possible the meniscus and capable of recruiting cells from within the meniscal cavity to differentiate these cells into the various types that make up a healthy meniscus.

"Both of these techniques require many years of research. To be successful we need a thorough understanding of how mesenchymal stem cells interact with scaffolds and how to optimise conditions promoting the cell growth around these scaffolds.

"The scaffold, while encouraging cell growth, must also degrade at the correct rate so that all that remains is meniscal tissue.

"We don't know which approach will be the most effective clinically, and this is why we are investigating the possibility of the artificial environment as well as the insertion method."

Dr Cooper-White said the research team also needed to be able to grow, or manufacture, the artificial meniscus reliably and quickly, suiting the circumstances of each patient.
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