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A synthetic meniscus prosthesis can help people with knee pain get rid of their symptoms. The prosthesis was developed by ATRO Medical, a spinoff of the Radboudumc. ReumaNederland will support the further development of the meniscus.

This year a clinical study will start in several Dutch hospitals, including the Radboudumc and the Maartenskliniek. In 2019, the meniscus prosthesis was already placed in five patients as part of the study.

In the Netherlands alone, there are around 40,000 keyhole surgeries each year in which damage to the meniscus is diagnosed and (part of) the meniscus is removed. For example, as a result of a sports injury (a ‘soccer knee’) or osteoarthritis.

Tony van Tienen

It is estimated that a quarter of these patients continue to suffer from pain afterward. With the help of medication and physiotherapy, they now have to wait until they are eligible for a completely new knee. “A drastic operation, while their symptoms are initially caused because their meniscus is broken,” says Tony van Tienen, orthopedist at the Laurentius Hospital in Roermond, a researcher at the Radboudumc, and Chief Medical Officer at Atro Medical. As an orthopedist, he has been involved in knee surgery in general and the meniscus in particular for over twenty years.

Fixation proves to be complicated

The desire to be able to replace the meniscus has existed since the 1980s, but the problem was finding the appropriate material to place in the body. Van Tienen: “The knee is very strong and grinds up everything that comes between it. Therefore, an artificial meniscus must be flexible but at the same time very strong.”

ReumaNederland invested ten years ago in research at the Radboudumc into new materials for prostheses. Eventually, in collaboration with several universities and Royal DSM, the solution was found through the application of Polycarbonate Urethane. This synthetic product has been used in the body for some time and has now proven its safety, for example in intervertebral discs and cardiac catheters. “The material alone is not enough. The knee must be able to move properly and the fixation of the artificial meniscus appears to be very complicated,” says Van Tienen. “The real meniscus is attached to the bone with small tendons and it is difficult to imitate the working of these tendons.”

Quality of life


Through the orthopedic start-up ATRO Medical, located at the Novio Tech Campus in Nijmegen, the scientific knowledge is further developed into an applicable product. ReumaNederland supports the new treatment because it can significantly improve the quality of life for patients with daily pain or knee osteoarthritis.

In the new clinical study this year, about ten patients will receive the prosthesis. After that, follow-up studies are needed. Van Tienen estimates that the artificial meniscus will be ready for an introduction to the European market around 2024. This market is considerable. Van Tienen: “In the Netherlands, it is potentially about 10,000 new patients a year, across Europe about 100,000 people. That’s not even mentioning the United States or Asia.”