MEFISTO will develop two novel solutions to treat meniscus loss as a strategy for preventing the onset of an epidemic of post-meniscectomy knee osteoarthritis (OA) in Europe.
Morphological profiling will identify the population of patients who, after meniscal resection, are at higher risk of early compartment degeneration, providing a personalized approach for the patient. The two different reconstructive strategies are:
i) a controlled vascularized bioactive resorbable meniscal scaffold which will regenerate the native meniscus. This strategy will be addressed to younger patients with early osteoarthritic changes.
ii) a bioactive non-resorbable meniscal prosthesis which will act as a mechanical unloading device and a drug delivery system, with the capacity to modulate the inflammatory environment. This strategy will be addressed to patients with advanced osteoarthritis.
A socio-economic analysis of the efficacy of existing meniscal substitutes will complete the project. This analysis is of vital importance for the European healthcare system: it will provide a clear understanding of the costs and benefits of current clinical practice and allow the development of a best practice approach.
The technological innovation lies in the development of biologically active functionalized nanobiomaterials that can interact with the surrounding articular tissues. In particular, an innovative meniscal scaffold will promote revascularization in the peripheral zone, while leaving the inner avascular, as happens in the native meniscal tissue. This concept is missing in current therapeutic approaches.
The expected potential impact is huge as so many patients have undergone, and will undergo, meniscectomies. The interventions developed in MEFISTO will prevent these patients from receiving joint-sacrificing procedures such as metal prosthesis and reduce the social burden, associated costs and high levels of morbidity resulting from OA.