Abstract

After partial or total meniscus resection, cartilage degeneration can be observed in many knee joints, frequently culminating in osteoarthritic changes. Therefore, a meniscus preserving therapy should be performed whenever possible. However, despite improved surgical techniques and new treatment strategies, meniscal tissue resection cannot always be avoided. Currently, only few treatment options are available after total meniscectomy, a dissatisfying situation considering that many patients presenting with meniscal injuries are young patients. Transplantation of allogenous menisci has been valuable only in particular cases and does not seem to prevent degenerative changes in the affected knee joint. Because of the unsatisfactory clinical progression after resection of meniscal tissue, new tissue engineering concepts are eagerly sought after. A first step towards a meniscus replacement therapy has been achieved with the development of a collagen meniscus implant (CMI), which has recently been approved for clinical application in Europe. This review will give a short overview about actual meniscus replacement therapies. Current experimental research concepts for meniscus tissue engineering and new perspectives for clinical treatment strategies will also be presented. Additionally, we will report about successful experimental application of new scaffolds and scaffolding materials, the use of different cell types and gene therapy approaches.

Keywords: Collagen meniscus implant, tissue engineering, meniscus defect, scaffold material, progenitor cells, gene therapy