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Meniscal Injuries pp 89–103Cite as

Basic Science of Meniscus Repair: Limitations and Emerging Strategies

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Abstract

Meniscal tears, especially in the inner avascular zone, have limited healing capacity and a high failure rate when repair is attempted. Endogenous repair, characterized by cell proliferation and matrix deposition at the injury site, is hindered by a lack of vascular supply, low cell density, and a catabolic state induced by inflammation. To biologically augment the healing response, experimental methods have focused on directly addressing these issues by enhancing vascularity, increasing cellularity, and providing an instructive extracellular environment via biochemical and mechanical cues. With further clinical development, these emerging regenerative strategies have potential to render meniscal repair a favorable operation in patients who would otherwise undergo partial meniscectomy (removal of the damaged segment).

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Abbreviations

ACI:

Autologous chondrocyte implantation

bFGF:

Basic fibroblast growth factor

CMI:

Collagen meniscus implant

ECM:

Extracellular matrix

GFP:

Green fluorescent protein

IGF-1:

Insulin-like growth factor 1

IL-1ra:

IL-1 receptor antagonist

IL-1β:

Interleukin-1beta

MMP:

Matrix metalloproteinase

MSC:

Mesenchymal stem cell

PCP:

Perimeniscal capillary plexus

PDGF-AB:

Platelet-derived growth factor AB

TGF-β:

Transforming growth factor beta

TNFα:

Tumor necrosis factor alpha

TNFα mAB:

Anti-TNFα monoclonal antibody

VEGF:

Vascular endothelial growth factor

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Acknowledgments

This work was supported by the National Institutes of Health (R01 AR056624), the Department of Veterans Affairs (I01 RX000174), the Penn Center for Musculoskeletal Disorders, and the Musculoskeletal Transplant Foundation. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the National Institutes of Health, Department of Veterans Affairs, or the US government.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, 36th Street and Hamilton Walk, Philadelphia, PA, 19104, USA

    Feini Qu B.S.E. & Matthew B. Fisher Ph.D.

  2. Mckay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA

    Robert L. Mauck Ph.D.

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  1. Feini Qu B.S.E.
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  2. Matthew B. Fisher Ph.D.
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  3. Robert L. Mauck Ph.D.
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Correspondence to Robert L. Mauck Ph.D. .

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  1. Hospital of the Uni. of Pennsylvania, Philadelphia, Pennsylvania, USA

    John D. Kelly, IV

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Qu, F., Fisher, M.B., Mauck, R.L. (2014). Basic Science of Meniscus Repair: Limitations and Emerging Strategies. In: Kelly, IV, J. (eds) Meniscal Injuries. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8486-8_10

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