Editorial Commentary: Biologic Augmentation of Meniscus Repair Is Complex

Editorial Commentary: Personalized Anterior Cruciate Ligament Reconstruction and Rehabilitation Mitigate Postoperative Arthrofibrosis: Prevention Is the Best Approach

Arthrofibrosis after anterior cruciate ligament reconstruction can become a major complication requiring surgical intervention. The reported incidence approximates 8% but varies widely (2%-35%) and, as not all patients require surgery, may be underreported. Several risk factors are involved. Female sex, older age, surgery within the first month after injury, and meniscus repair are consistently associated with increased risk. Other factors include graft size and type, concomitant procedures, use of anticoagulants, and genetic factors. By identifying risk factors, we can modify our surgical technique and rehabilitation to meet each patient's needs with fewer complications.

Repair of a Radial Tear of the Meniscus Augmented With a Biocomposite Scaffold

Meniscal tears are a common musculoskeletal pathology in the United States, affecting 61 in every 100,000 people. Surgical repair is indicated for certain tear patterns to reduce the risk of joint degeneration, normalize contact forces in the knee, and help restore normal knee kinematics. However, radial meniscus tear repairs fail to completely heal 38% of the time due to tear characteristics, biology, surgical technique, and inadequate rehabilitation. Recent efforts have incorporated biological augmentation to enhance the healing potential of the meniscus. The BioBrace is a biocomposite scaffold designed to mechanically reinforce tissue and biologically enhance healing. The purpose of this article is to describe an all-inside, meniscal radial tear repair augmented with BioBrace.

Editorial Commentary: Meniscus Regeneration Based on Adipose-Derived Stem Cells: How Far Are We From Clinical Application?

The goal of meniscal tissue engineering is tissue remodeling and functional recovery. Autologous, tissue-engineered adipose-derived stem cell (ADSC) sheets promote meniscal regeneration in rabbit meniscal defects in vivo. Moreover, compared with a control group, in the ADSC sheet model, both histologic scores and gene expression are more similar to normal meniscal tissue. ADSC sheets promote meniscal regeneration regardless of whether the defect involves the whole width or inner half of a meniscal defect. Mechanical properties are also important, and experimental data show encouraging mechanical properties of meniscus tissue reconstructed from ADSC sheets. Cell sheet technology is a promising therapeutic strategy for meniscal regenerative medicine and tissue engineering. Theoretically, cell sheet transplantation could result in superior outcomes to traditional cell-free scaffolds, and further research is needed before clinical application.