Das künstliche meniskusimplantat

Meniscus replacement attained an increased priority in the last decade. Precursors made from non-absorbable synthetics, such as dacron or teflon, were abandoned due to abrasive wear and the resulting synovitis. Also the application of autologous tissue in the form of fat, periosteum or tendons did not prove to be suitable for meniscus replacement. The experiments in the last 15 years pointed to the development of absorbable porous meniscus scaffolds. Various materials and polymers made from collagens, polyurethanes, polylactates, polyglycols, gelatines, hyaluronic acid, capronolactones or alcohol hydrogels were investigated in numerous experiments. Most of these constructs showed good biocompatibility, integration, absorption and regeneration. In the meantime, two implants have been clinically introduced. The collagen meniscus implant (CMI®), first implanted in patients 13 years ago, was approved in the USA for inclusion in a multicenter study and, regardless lacking clinical data simultaneously in Europe for application in patients. Despite subjective improvements of symptoms in the few available clinical studies, a proof of improvements in meniscus function is still lacking. A porous polyurethane meniscus scaffold (Actifit®) is currently being tested in a clinical study.