Meniscus repair and regeneration: review on current methods and research potential

Abstract

Meniscus regeneration is an unsolved clinical challenge. Despite the wide acceptance of the degenerative consequences of meniscectomy, no surgical procedure has succeeded to date in regenerating a functional and long-lasting meniscal fibrocartilage. Research proposed a number of experimental approaches encompassing all the typical strategies of regenerative medicine: cellfree scaffolds, gene therapy, intra-articular delivery of progenitor cells, biological glues for enhanced bonding of reparable tears, partial and total tissue engineered meniscus replacement. None of these approaches has been completely successful and can be considered suitable for all patients, as meniscal tears require specific and patientrelated treatments depending on the size and type of lesion. Recent advances in cell biology, biomaterial science and bioengineering (e.g., bioreactors) have now the potential to drive meniscus regeneration into a series of clinically relevant strategies. In this tutorial paper, the clinical need for meniscus regeneration strategies will be explained, and past and current experimental studies on meniscus regeneration will be reported.

Application of cell and biomaterial-based tissue engineering methods in the treatment of cartilage, menisci and ligament injuries

“…The collagen-based meniscus implant (CMI) was the first technique of this type used for meniscus regeneration [64]. CMI is a resorbable type I collagen scaffold and was arthroscopically sutured to the remaining parts of the meniscus.…”

Biological Augmentation and Tissue Engineering Approaches in Meniscus Surgery

“…5,8 The provision of exogenous fibrin clot, growth factors, and cells from various sources to the meniscus repair site have also been previously noted in the literature. [9][10][11][12] Although the term "tissue engineering" has been applied to a multitude of biological strategies in previous literature, it correctly refers to the addition of cells or growth factors to a scaffold with the aim of host target tissue regeneration. This strategy may involve varying levels of focus on both ex vivo and in vivo meniscus tissue generation before and after implantation into the host.…”

Role of regeneration in tissue repairing and therapies

“…How long individually tailored stem cells can be used for therapeutic purposes will be new innovative areas of future research [183]. Thus by recruitment of intrinsic stem / progenitor cells in to the damaged sites can start regenerative activity and can make disable organs functional [184]. Similarly, induced neural cells may restore the memory in memory related diseases.…”