The menisci represent indispensable intraarticular components of a well-functioning knee joint. Sports activities, traumatic incidents, or simply degenerative conditions can cause meniscal injuries, which often require surgical intervention. Efforts in biomechanical and clinical research have led to the recommendation of a meniscus-preserving rather than a meniscus-resecting treatment approach. Nevertheless, partial or even total meniscal resection is sometimes inevitable. In such circumstances, techniques of meniscal substitution are required. Autologous, allogenic, and artificial meniscal substitutes are available which have evolved in recent years. Basic anatomical and biomechanical knowledge, clinical application, radiological and clinical outcomes as well as future perspectives of meniscal substitutes are presented in this article. A comprehensive knowledge of the different approaches to meniscal substitution is required in order to integrate these evolving techniques in daily clinical practice to prevent the devastating effects of lost meniscal tissue.
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http://dx.doi.org/10.1186/s40634-020-00270-6 | DOI Listing |
J ISAKOS
December 2024
Institut du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France. Electronic address:
Meniscectomy is known to alter the mechanics, stability, and kinematics of the tibiofemoral joint, leading to early knee osteoarthritis (KOA). While several meniscal substitutions exist, such as meniscus allograft transplantation, collagen meniscus implants, and artificial substitutes, they often come with technical challenges, high costs, and risks, including allograft failure, infections, and disease transmission. Tendon autografts emerge as a promising option, offering safety, availability, biocompatibility, and a reduced risk of pathophoresis.
View Article and Find Full Text PDFActa Biomater
October 2024
Department of Mechanical Engineering and Mechatronics, Ariel University, Ariel 407000, Israel. Electronic address:
The meniscus tissue is crucial for knee joint biomechanics and is frequently susceptible to injuries resulting in early-onset osteoarthritis. Consequently, the need for meniscal substitutes spurs ongoing development. The meniscus is a composite tissue reinforced with circumferential and radial collagenous fibers; the mechanical role of the latter has yet to be fully unveiled.
View Article and Find Full Text PDFPurpose: Meniscal injuries are common in knee surgery and often require preservation techniques to prevent secondary osteoarthritis. Despite advancements in repair techniques, some patients undergo partial meniscectomy, which can lead to postmeniscectomy syndrome. To address these challenges, meniscal substitution techniques like scaffolds have been developed.
View Article and Find Full Text PDFFront Bioeng Biotechnol
May 2024
Department of Medicine for Sports and Performing Arts, Osaka University Graduate School of Medicine, Osaka, Japan.
Biomechanical stimulation is reportedly pivotal in meniscal regeneration, although its effect on mesenchymal stem cell (MSC) meniscal differentiation remains elusive. In this study, we investigated how cyclic compressive loading (CCL) could impact MSCs using three-dimensional cultures in atelocollagen-based meniscal substitute (ACMS). We extracted MSCs from the meniscus, synovium, and articular cartilage, cultured them in three-dimensional cultures, and exposed them to CCL for 7 days.
View Article and Find Full Text PDFACS Biomater Sci Eng
April 2024
Tissue Engineering Group, Departmento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Av. Carrera 30 # 45-10, Bogotá 111321, D.C., Colombia.
The meniscus is divided into three zones according to its vascularity: an external vascularized red-red zone mainly comprising collagen I, a red-white interphase zone mainly comprising collagens I and II, and an internal white-white zone rich in collagen II. Known scaffolds used to treat meniscal injuries do not reflect the chemical composition of the vascular areas of the meniscus. Therefore, in this study, four composite zonal scaffolds (named A, B, C, and D) were developed and characterized; the developed scaffolds exhibited the main chemical components of the external (collagen I), interphase (collagens I/II), and internal (collagen II) zones of the meniscus.
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