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The Interplay of Biomechanical and Biological Changes Following Meniscus Injury

  • Osteoarthritis (MB Goldring and T Griffin, Section Editors)
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Abstract

Purpose of Review

Meniscus injury often leads to joint degeneration and post-traumatic osteoarthritis (PTOA) development. Therefore, the purpose of this review is to outline the current understanding of biomechanical and biological repercussions following meniscus injury and how these changes impact meniscus repair and PTOA development. Moreover, we identify key gaps in knowledge that must be further investigated to improve meniscus healing and prevent PTOA.

Recent Findings

Following meniscus injury, both biomechanical and biological alterations frequently occur in multiple tissues in the joint. Biomechanically, meniscus tears compromise the ability of the meniscus to transfer load in the joint, making the cartilage more vulnerable to increased strain. Biologically, the post-injury environment is often characterized by an increase in pro-inflammatory cytokines, catabolic enzymes, and immune cells. These multi-faceted changes have a significant interplay and result in an environment that opposes tissue repair and contributes to PTOA development. Additionally, degenerative changes associated with OA may cause a feedback cycle, negatively impacting the healing capacity of the meniscus.

Summary

Strides have been made towards understanding post-injury biological and biomechanical changes in the joint, their interplay, and how they affect healing and PTOA development. However, in order to improve clinical treatments to promote meniscus healing and prevent PTOA development, there is an urgent need to understand the physiologic changes in the joint following injury. In particular, work is needed on the in vivo characterization of the temporal biomechanical and biological changes that occur in patients following meniscus injury and how these changes contribute to PTOA development.

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Funding

This paper was funded in part by NIH grants AR079184, AR065527, AR074800, AR078245, and AR073221.

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  1. Patrick X. Bradley and Karl N. Thomas both  contributed equally.

  2. Louis E. DeFrate and Amy L. McNulty both  contributed equally.

Authors and Affiliations

  1. Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA

    Patrick X. Bradley & Louis E. DeFrate

  2. Department of Orthopaedic Surgery, Duke University School of Medicine, DUMC Box 3093, Durham, NC, 27710, USA

    Karl N. Thomas, Allison C. Robinson, Jocelyn R. Wittstein, Louis E. DeFrate & Amy L. McNulty

  3. Department of Biomedical Engineering, Duke University, Durham, NC, USA

    Avery L. Kratzer, Louis E. DeFrate & Amy L. McNulty

  4. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    Amy L. McNulty

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Bradley, P.X., Thomas, K.N., Kratzer, A.L. et al. The Interplay of Biomechanical and Biological Changes Following Meniscus Injury. Curr Rheumatol Rep 25, 35–46 (2023). https://doi.org/10.1007/s11926-022-01093-3

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