MEFISTO - Progress in Meniscus Regeneration
What clinical problem does MEFISTO address?
A meniscus injury is the most frequent knee injury and reason for orthopedic surgery. If an injured meniscus cannot be restored, the damaged part must be removed to relieve pain. Although nowadays it is undisputed that a missing meniscus can lead to premature degeneration of the knee joint in the longer term, a meniscus is still removed in many cases. This is where MEFISTO comes in and wants to offer patients an alternative. Geistlich has been exploring the possibility of meniscus repair with existing products for several years. As we are known as a regeneration specialist, our network gave us the impetus to look for joint innovative solutions.
What is the goal of MEFISTO?
The aim of the MEFISTO project is to develop innovative, bioactive products to replace missing meniscus tissue. We want to regenerate the meniscus function in a way that is joint-friendly. In this way, we can prevent knee degeneration or at least slow it down. The project is based on three pillars: It starts with a morphological profile of patients with meniscus loss: new findings on different geometries and shapes of the knee joints and on symptomatology gained from the project itself. These form the basis for the development of an algorithm that can be used to assign the optimal treatment to each patient.
In addition to the algorithm, the project stands on two other main pillars, on which ones?
Secondly, we are developing a regenerative, resorbable biomaterial with our partners. What is special about this is that it is functionalized, i.e. specific molecules actively promote the regeneration of the meniscus. These biofunctional molecules are arranged in the product in a zone-specific manner and act over a shorter or longer period of time, depending on the type of molecule. Third, our collaboration partners are working on a permanent implant that is used when the cartilage is already more degenerated and inflamed after meniscus loss. It takes over the mechanical function of the missing meniscus and unloads the articular joint surface. To counteract the inflammatory reaction, this implant is also enriched with biofunctional molecules.
What role does Geistlich have in this project?
Geistlich was already active in the conception of the project idea and as project coordinator is a driving force in the consortium of 13 international members. The group of 13 consists of 8 academic partners and 5 partners from industry. Here Geistlich is the largest industrial partner and brings many years of comprehensive experience from the development to marketing of products. Geistlich, as a regeneration specialist, is also actively involved in the project through the development of regenerative collagen products. So, we cover several aspects and bring the expertise and prospect necessary for later successful positioning of products on the market.
What does that mean in concrete terms?
There are numerous operational issues that want to be addressed early in the research phase and in which we are very experienced. For example: Which collagens can be implanted later in humans? How can we process a collagen in a zone-specific way? Which packaging is suitable? Which sterilization method is suitable? Where can we find the best certified suppliers for raw materials? We are even evaluating issues such as storage conditions for the resulting product. Our collagen expertise and wealth of experience in product development are benefiting the project.
What is the duration of MEFISTO and where are we today?
The project started in summer 2019 and will last until 2024. The collection of raw data for the algorithm has been completed. The 3D-printed resorbable as well as the non-resorbable implant prototypes are also promising. Today, we are in an interesting consolidation phase in which we are applying what we have learned so far to produce different prototypes. Subsequently, these will be evaluated by surgeons and the regenerative potential in biological systems will be investigated.
What is the special promise of 3D printing in a project like this?
With MEFISTO, we are taking a further step towards personalized medicine: 3D printing can be used to produce products that are tailored to the individual shape of the patient's knee. 3D printing also enables the precise positioning of biofunctional molecules, which then act in the knee where they are needed.
Many thanks for this interview, Niklaus Stiefel
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 814444 (MEFISTO).