AUGMENTED MENISCAL HEALING WITH FREE SYNOVIAL AUTOGRAFTS - AN ORGAN-CULTURE MODEL

We examined whether or not free synovial autografts can augment the he aling of lesions artificially created in the human knee meniscus in an organ culture model. The effectiveness of free synovial autografts wa s also compared with that of fibrin glue (Tisseel). In the control gro up, the accumulation of cellular components increased at the edge of a 4-mm meniscal defect following culture, although no cells were found to invade the defect. In the fibrin glue group, an increased migration of cells into fibrin glue packed into the defect was observed until 4 weeks following cultivation. However, newly formed collagen produced by the cells in the fibrin glue was minimal even 4 weeks after cultiva tion. In contrast, in the synovial group, newly formed collagen produc tion, as well as cellular proliferation, increased in the grafted syno vium with time after cultivation. By 4 weeks, the gap between the edge of the defect and the grafted synovium was bridged by newly formed co llagen tissue, indicating improved histologic repair. Our results sugg est that free autogenous synovial tissue grafts in meniscal lesions ar e superior to fibrin glue, and that interpositional synovial autograft s to augment repair of meniscal tears in the avascular zone may be cli nically useful.