Principles and decision making in meniscal surgery.

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Abstract

[Indexed for MEDLINE] 3. Biomater Biosyst. 2021 Aug 26;4:100026. doi: 10.1016/j.bbiosy.2021.100026. eCollection 2021 Dec. A review of strategies for development of tissue engineered meniscal implants. Klarmann GJ(1)(2), Gaston J(1)(2), Ho VB(1). Author information: (1)4D Bio³ Center, Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA. (2)The Geneva Foundation, 917 Pacific Ave., Tacoma, WA 98402, USA. The meniscus is a key stabilizing tissue of the knee that facilitates proper tracking and movement of the knee joint and absorbs stresses related to physical activity. This review article describes the biology, structure, and functions of the human knee meniscus, common tears and repair approaches, and current research and development approaches using modern methods to fabricate a scaffold or tissue engineered meniscal replacement. Meniscal tears are quite common, often resulting from sports or physical training, though injury can result without specific contact during normal physical activity such as bending or squatting. Meniscal injuries often require surgical intervention to repair, restore basic functionality and relieve pain, and severe damage may warrant reconstruction using allograft transplants or commercial implant devices. Ongoing research is attempting to develop alternative scaffold and tissue engineered devices using modern fabrication techniques including three-dimensional (3D) printing which can fabricate a patient-specific meniscus replacement. An ideal meniscal substitute should have mechanical properties that are close to that of natural human meniscus, and also be easily adapted for surgical procedures and fixation. A better understanding of the organization and structure of the meniscus as well as its potential points of failure will lead to improved design approaches to generate a suitable and functional replacement. © 2021 The Authors. Published by Elsevier Ltd. DOI: 10.1016/j.bbiosy.2021.100026 PMCID: PMC9934480