Abstract
Menisci are crucial structures for knee homeostasis. After a meniscal lesion, the golden rule, now, is to save as much meniscus as possible; only the meniscus tissue that is identified as unrepairable should be excised, and meniscal sutures find more and more indications. Several different methods have been proposed to improve meniscal healing. They include very basic techniques, such as needling, abrasion, trephination and gluing, or more complex methods, such as synovial flaps, meniscal wrapping or the application of fibrin clots. Basic research of meniscal substitutes has also become very active in the last decades. The aim of this literature review is to analyze possible therapeutic and surgical options that go beyond traditional meniscal surgery: from scaffolds, which are made of different kind of polymers, such as natural, synthetic or hydrogel components, to new technologies, such as 3-D printing construct or hybrid biomaterials made of scaffolds and specific cells. These recent advances show that there is great interest in the development of new materials for meniscal reconstruction and that, with the development of new biomaterials, there will be the possibility of better management of meniscal injuries
Highlights
Koller et al tried to increase the biological activity of polymeric scaffolds by adding polyethylene terephthalate (PET) to PCL scaffolds: they showed that PET scaffolds increase the production of collagen II mRNA and the secretion of glycosaminoglycans [55] when added to a scaffold made of a hyaluronic acid/polycycaprolactone biomaterial
The meniscus is a fundamental structure for knee homeostasis
The optimization of the treatment of meniscal injuries remains a challenge of paramount importance, which requires advanced therapeutic strategies based on the recognition of the pathophysiology of the damage and the restoration of joint biomechanics in order to avoid the arthritic evolution
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. They were defined in 1897 as “functionless remnants of leg muscle origin” [1]; today, they are considered as structures of fundamental importance for maintaining the integrity of the knee joint homeostasis Among their functions, we must remember the increase in congruence between the articular surfaces of the distal femur and tibial plateau, bear loading, shock absorption, lubrication and proprioception [2]. The menisci have the important function of augmenting the congruence between the femoral and tibial condyles, increasing the joint compliance, which is a requirement for the lubrication of the fluid film and normal circulation of synovial fluid within the knee [8].
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