In Vitro Meniscus Integration Potential is Inversely Correlated With Tissue Maturation State

Abstract

Meniscal surgeries are amongst the most common procedures performed in orthopedics today. Clinical solutions are few and have limited success, and so partial meniscectomy is a common outcome. While tears are common in older patients, few young patients present with meniscus damage. It is unclear whether juvenile menisci are less susceptible to damage or more given to endogenous repair. Early in development, the menisci are well vascularized throughout their radial expanse, while in adults, vascularity is restricted to the peripheral rim of the tissue, near the synovial margin [1]. Tears in this vascular region often do heal in adults, while those in the avascular inner regions of the tissue do not [2]. This has led to the inference that vascularity is essential for meniscus healing and this manner of thinking has directed numerous repair strategies toward that end [3].

Contact models of repaired articular surfaces: influence of loading conditions and the superficial tangential zone

“…While efforts to create repair tissues have become more sophisticated resulting in better outcomes, the goal of achieving normal zonal properties in vitro or in vivo has not yet been achieved (Chiang and Jiang 2009;Iwasa et al 2009;Klein et al 2009a,b;Ng et al 2009;Revell and Athanasiou 2009). It has also been suggested, however, that healing conditions may require initial material properties that differ from normal tissue (Frank et al 2004;Ionescu et al 2010). An important consideration is that transplanted constructs must have sufficient mechanical quality in order to survive the healing process in vivo under the demanding mechanical environment of the joint.…”