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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2007 April;58(2):179-91
Meniscus tears: current strategies for repair, rehabilitation and the future of tissue engineering
Dutcheshen N. T., Adams S. B., Randolph M. A., Gill T. J.
Laboratory for Musculoskeletal Tissue Engineering Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Injury to the meniscus is a common occurrence in today’s active society. It is frequently the cause of pain, swelling and mechanical symptoms in the knee. Despite its frequent presentation, the decision to repair or resect a torn meniscus is not always straight forward. Current repair techniques are moderately effective in the peripheral vascularized meniscus. However, meniscus repair in the avascularized zones has proven unsuccessful. Tissue engineering, a discipline that combines the technologies of cell culture and biodegradable scaffolds to deliver a cellular repair, is thought to be the future answer to this problem. The concept of using cell-based repair for torn menisci could improve healing of lesions in the vascular zone as well as make repair a possible option in the avascular zones. This article reviews the current indications for meniscal repair, techniques for repair, postoperative rehabilitation protocols, advances in the field of tissue engineering toward the development of a tissue-engineered meniscal repair technique, and the current state of engineering an implantable, artificial meniscus.