Preservation Methods Influence the Biomechanical Properties of Human Lateral Menisci: An Ex Vivo Comparative Study of 3 Methods.

• Jacquet Christophe
• Erivan Roger
• Sharma Akash
• Pithioux Martine
• Parratte Sebastien
• Argenson Jean-Noël
• Ollivier Matthieu

• Allograft
• Conservation
• Cryopreservation
• Freezing
• Irradiation
• Mechanical properties
• Meniscus
• Storage

BACKGROUND: Three main meniscal preservation methods have been used over the past decade: cryopreservation, freezing, and freezing with gamma irradiation. HYPOTHESIS: All 3 preservation methods will result in similar biomechanical properties as defined by tensile and compression testing. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 24 human lateral menisci were collected from patients who underwent total knee arthroplasty. Inclusion criteria were patients younger than 70 years with primary unilateral (medial) femorotibial knee osteoarthritis. Each meniscus was divided into 2 specimens cross-sectionally. One specimen was systematically cryopreserved and constituted the control (Cy; -140°C), and the other specimen was used for either the simple frozen group (Fr; -80°C) or the frozen+irradiated group (FrI; -80°C + 25-kGy irradiation). Compression and tensile tests were performed to analyze the elasticity modulus (Young modulus) in compression, the elasticity modulus in tension, the tensile force at failure, and the rupture profile of the tensile stress-strain curve. RESULTS: A significant difference in the mean compression elasticity modulus was observed between the Cy and Fr groups (28.86 ± 0.77 vs 37.26 ± 1.08 MPa, respectively; P \textless .001) and between the Cy and FrI groups (28.86 ± 0.77 vs 45.92 ± 1.09 MPa, respectively; P \textless .001). A significant difference in the mean tensile elasticity modulus was also observed between the Cy and Fr groups (11.66 ± 0.97 vs 19.97 ± 1.37 MPa, respectively; P = .008) and between the Cy and FrI groups (11.66 ± 0.97 vs 45.25 ± 1.39 MPa, respectively; P \textless .001). There were no significant differences between the control and study groups in tensile force at failure. The analysis of the stress-strain curve revealed a slow-slope curve with a nonabrupt rupture (ductile material) for the Cy samples versus a clear rupture of the curve for the Fr and FrI samples (more fragile material). CONCLUSION: Cryopreservation allows for more elastic and less fragile tissue compared with simple freezing or freezing plus irradiation. CLINICAL RELEVANCE: The study results exhibit the detrimental effect of simple freezing and freezing plus irradiation on human meniscal mechanical properties. If these effects occur in menisci prepared for allograft procedures, important differences could appear in the graft's mechanical behavior and thus patient outcomes.