Basic science of meniscus repair: Limitations and emerging strategies

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).