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Basic Science of Meniscus Repair: Limitations and Emerging Strategies

  • Feini Qu
  • Matthew B. Fisher
  • Robert L. MauckEmail author
Chapter

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).

Keywords

Vascular Endothelial Growth Factor Meniscal Tear Fibrin Clot Meniscus Repair Bone Marrow MSCs 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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

Notes

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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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Feini Qu
    • 1
  • Matthew B. Fisher
    • 1
  • Robert L. Mauck
    • 2
    Email author
  1. 1.Department of Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Mckay Orthopaedic Research LaboratoryUniversity of PennsylvaniaPhiladelphiaUSA

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