Tissue adhesives for meniscus tear repair: an overview of current advances and prospects for future clinical solutions

Abstract

Menisci are crucial structures in the knee joint as they play important functions in load transfer, maintaining joint stability and in homeostasis of articular cartilage. Unfortunately, ones of the most frequently occurring knee injuries are meniscal tears. Particularly tears in the avascular zone of the meniscus usually do not heal spontaneously and lead to pain, swelling and locking of the knee joint. Eventually, after a (partial) meniscectomy, they will lead to osteoarthritis. Current treatment modalities to repair tears and by that restore the integrity of the native meniscus still carry their drawbacks and a new robust solution is desired. A strong tissue adhesive could provide such a solution and could potentially improve on sutures, which are the current gold standard. Moreover, a glue could serve as a carrier for biological compounds known to enhance tissue healing. Only few tissue adhesives, e.g., Dermabond® and fibrin glue, are already successfully used in clinical practice for other applications, but are not considered suitable for gluing meniscus tissue due to their sub-optimal mechanical properties or toxicity. There is a growing interest and research field focusing on the development of novel polymer-based tissue adhesives, but up to now, there is no material specially designed for the repair of meniscal tears. In this review, we discuss the current clinical gold standard treatment of meniscal tears and present an overview of new developments in this field. Moreover, we discuss the properties of different tissue adhesives for their potential use in meniscal tear repair. Finally, we formulate recommendations regarding the design criteria of material properties and adhesive strength for clinically applicable glues for meniscal tears.

RETRACTED: A Bio Polymeric Adhesive Produced by Photo Cross-Linkable Technique

“…The final dimension of the glued gelatin films was 1.5 cm ¢ 5 cm. We used ultra violet radiation to treat them using the same conditions as previously described by different authors [21][22][23][24]. Using this…”

Efficacy of administered mesenchymal stem cells in the initiation and co‐ordination of repair processes by resident disc cells in an ovine (Ovis aries) large destabilizing lesion model of experimental disc degeneration

“…Frog glue has been used to re‐attach infraspinatus tendon in rotator cuff repair, and bucket handle meniscal tears . New Zealand green lipped mussel and barnacle glues also have strong adhesive properties suitable for orthopedic applications, but await commercialisation …”

“…135,136 New Zealand green lipped mussel and barnacle glues also have strong adhesive properties suitable for orthopedic applications, but await commercialisation. [137][138][139][140][141] The low number of cells in the mature AF of advanced stages of senescence exclude them as a suitable cell source for the seeding of scaffolds. MSCs are a useful alternative cell type for annular repair and have been isolated from annular tissues of normal and degenerate…”

Cyanoacrylic tissue glues: Biochemical properties and their usage in urology

“…[1] Cyanoacrylic (CA) glues are synthetic, and hybrid tissue sealants, belonging to a chemical group which demonstrates strong, and rapidly acting adhesive properties, and used prevalently in industry, medicine, and household activities. CA family is termed based on cyano, and ethylene groups, and variable alkyl groups, and consists of methyl-2-cyanoacrylate (2-MCA), ethyl-2-cyanoacrylate (2-ECA), n-butyl-cyanoacrilate (nBCA), isobutyl cyanoacrilate, octyl cyanoacrylate (OCA), and 2-octyl cyanoacrylate (2-OCA) ( Figure 1).…”