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Bioengineering
Special Issues
Novel Techniques in Meniscus Repair
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Novel Techniques in Meniscus Repair

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Regenerative Engineering".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 6087

Editors

Dr. Yuya Kodama

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Mizushima Central Hospital, 4-5 Aobacho, Mizushima Minamiku, Kurashiki 712-8064, Japan
Interests: meniscus repair; arthroscopic surgery; meniscal root tear; knee joint preservation; meniscal healing; sports medicine; regenerative orthopedics
Dr. Yuki Okazaki

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City 700-8558, Okayama, Japan
Interests: arthroscopy; ligament; meniscus; cartilage; osteoarthritis; biology; animal model

Special Issue Information

Dear Colleagues,

Meniscal preservation and repair are rapidly evolving fields in orthopedic surgery, driven by the recognition that maintaining meniscal integrity is crucial for joint biomechanics, cartilage protection, and long-term knee function. In recent years, novel surgical techniques, implant designs, and biological augmentation strategies have significantly advanced the outcomes of meniscus repair. These innovations reflect a shift from meniscectomy toward meniscal preservation and regeneration.

This Special Issue on "Novel Techniques in Meniscus Repair" aims to highlight the latest advancements in the surgical management of meniscal injuries, including both experimental and clinical studies. We welcome original research articles and comprehensive reviews that explore emerging technologies, refined repair techniques, and novel biological approaches intended to improve healing and long-term joint preservation.

Topics of interest for this Special Issue include, but are not limited to, the following:

  • Novel arthroscopic repair techniques and instrumentation;
  • Biomechanical evaluations of new repair strategies;
  • Meniscal root and ramp lesion repair innovations;
  • Augmentation with scaffolds, biologics, or cellular therapies;
  • Imaging-guided assessment and surgical planning;
  • Postoperative rehabilitation protocols optimized for tissue healing;
  • Long-term clinical and radiologic outcomes of advanced repair techniques;
  • Basic science studies on meniscal biology and healing mechanisms.

All submissions that contribute to a deeper understanding of innovative meniscus repair approaches and their clinical applications are highly encouraged.

Dr. Yuya Kodama
Dr. Yuki Okazaki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • meniscus repair
  • arthroscopic surgery
  • meniscal root tear
  • biologic augmentation
  • knee joint preservation
  • meniscal healing
  • sports medicine
  • regenerative orthopedics

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Published Papers (4 papers)

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Research

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26 pages, 8569 KB  
Article
Pneumatospinning and Electrospinning Scaffolds for Meniscus Regeneration Using Human Embryonic-Derived Mesenchymal Stem Cells
by Shawn P. Grogan, Erik W. Dorthé, Austin B. Williams, Nicholas E. Glembotski and Darryl D. D’Lima
Bioengineering 2026, 13(3), 314; https://doi.org/10.3390/bioengineering13030314 - 9 Mar 2026
Cited by 1 | Viewed by 1073
Abstract
We evaluated human embryonic stem cell-derived mesenchymal stem cells (ES-MSCs) on collagen scaffolds for meniscus-like neotissue formation and ex vivo repair of human osteoarthritic (OA) meniscal defects. Collagen type I fibrous scaffolds were pneumatospun, and laminate scaffolds were fabricated from electrospun PLA/collagen; crosslinked; [...] Read more.
We evaluated human embryonic stem cell-derived mesenchymal stem cells (ES-MSCs) on collagen scaffolds for meniscus-like neotissue formation and ex vivo repair of human osteoarthritic (OA) meniscal defects. Collagen type I fibrous scaffolds were pneumatospun, and laminate scaffolds were fabricated from electrospun PLA/collagen; crosslinked; heparin conjugated; fibronectin coated; functionalized with TGFβ1, TGFβ3, or PDGFbb; seeded with ES-MSCs; and cultured for 4 weeks, followed by in vitro assessment or ex vivo implantation into 3.5 mm human meniscus defects for 5 weeks. Pneumatospinning generated highly porous scaffolds that supported uniform cell infiltration, while laminate scaffolds demonstrated interlocking fiber interfaces and enhanced mechanical properties. TGFβ1 and TGFβ3 immobilization enhanced scaffold bioactivity, defined as growth factor-mediated increases in meniscus-like matrix deposition, collagen fiber organization, and meniscogenic gene expression, by significantly increasing safranin O staining, collagen type II deposition, collagen fiber polarization, and ACAN expression. TGFβ3 additionally increased COL1A1 expression and pushout shear modulus; TGFβ1 increased peak pushout stress, indicating superior ex vivo mechanical integration. Laminate scaffolds resulted in extensive cell infiltration, robust neotissue formation (elastic modulus ~2.4 MPa), and improved ex vivo tissue integration when functionalized with TGFβ3. The data indicated that ES-MSC-seeded, heparin-conjugated, TGFβ-immobilized pneumatospun/electrospun collagen–PLA scaffolds support meniscogenic differentiation and biomechanical integration, with repair of focal meniscal defects and potential for partial meniscus replacement. Full article
(This article belongs to the Special Issue Novel Techniques in Meniscus Repair)
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20 pages, 5290 KB  
Article
Time-Dependent Anchor Hole Expansion May Associate with Meniscal Extrusion After Open-Wedge High Tibial Osteotomy Combined with Medial Meniscus Posterior Root Tear Repair and Meniscal Centralization
by Yohei Maeda, Ryuichi Nakamura, Kaori Matsumoto, Satomi Abe and Hiroshi Ito
Bioengineering 2026, 13(2), 162; https://doi.org/10.3390/bioengineering13020162 - 29 Jan 2026
Viewed by 933
Abstract
Background: This study evaluated time-dependent changes in anchor hole width (AHW) and their association with postoperative medial meniscus extrusion (MME) in patients undergoing open-wedge high tibial osteotomy (OWHTO) with medial meniscus posterior root tear (MMPRT) repair and meniscal centralization. Methods: Thirty knees treated [...] Read more.
Background: This study evaluated time-dependent changes in anchor hole width (AHW) and their association with postoperative medial meniscus extrusion (MME) in patients undergoing open-wedge high tibial osteotomy (OWHTO) with medial meniscus posterior root tear (MMPRT) repair and meniscal centralization. Methods: Thirty knees treated with combined OWHTO and MMPRT repair using the centralization technique were retrospectively reviewed. MRI, CT, and second-look arthroscopy were performed preoperatively and postoperatively. AHW of the MMPRT anchor and two centralization anchors (midbody and midbody–posterior, M-anchor and MP-anchor) were measured on multiplanar reconstruction CT images at 1, 3, and 6 months, and 1 year, and their correlations with postoperative MME were analyzed. Results: AHW increased up to 3 months and gradually decreased with surrounding sclerosis by 1 year. The M-anchor showed significantly greater mediolateral (ML) expansion than the MP-anchor and demonstrated a moderate positive correlation between 1-year AHW and MME (r ≈ 0.5, p < 0.01). Second-look arthroscopy confirmed a 90% healing rate of the repaired root. Conclusions: Although OWHTO combined with MMPRT repair and centralization achieved favorable root healing, postoperative MME progression was not fully prevented. Time-dependent ML anchor hole expansion around the M-anchor may indicate persistent micromotion, elongation of the meniscotibial ligament, and degenerative stretch of the repaired meniscus following healing, suggesting that even after successful root healing, ML motion remains difficult to control, highlighting the need for biomechanically optimized fixation. Full article
(This article belongs to the Special Issue Novel Techniques in Meniscus Repair)
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Review

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18 pages, 1606 KB  
Review
Biologic Augmentation for Meniscus Repair: A Narrative Review
by Tsung-Lin Lee and Scott Rodeo
Bioengineering 2026, 13(1), 101; https://doi.org/10.3390/bioengineering13010101 - 15 Jan 2026
Viewed by 1865
Abstract
Meniscal preservation is increasingly recognized as a critical determinant of long-term knee joint health, yet successful repair remains challenging due to the meniscus’s limited intrinsic healing capacity. The adult meniscus is characterized by restricted vascularity, low cellularity, a dense extracellular matrix, complex biomechanical [...] Read more.
Meniscal preservation is increasingly recognized as a critical determinant of long-term knee joint health, yet successful repair remains challenging due to the meniscus’s limited intrinsic healing capacity. The adult meniscus is characterized by restricted vascularity, low cellularity, a dense extracellular matrix, complex biomechanical loading, and a hostile post-injury intra-articular inflammatory environment—factors that collectively impair meniscus healing, particularly in the avascular zones. Over the past several decades, a wide range of biologic augmentation strategies have been explored to overcome these barriers, including synovial abrasion, fibrin clot implantation, marrow stimulation, platelet-derived biologics, cell-based therapies, scaffold coverage, and emerging biologic and biophysical interventions. This review summarizes the biological basis of meniscal healing, critically evaluates current and emerging biologic augmentation techniques, and integrates these approaches within a unified framework of vascular, cellular, matrix, biomechanical, and immunologic targets. Understanding and modulating the cellular and molecular mechanisms governing meniscal degeneration and repair may enable the development of more effective, mechanism-driven strategies to improve healing outcomes and reduce the risk of post-traumatic osteoarthritis. Full article
(This article belongs to the Special Issue Novel Techniques in Meniscus Repair)
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15 pages, 270 KB  
Review
All-Inside Versus Inside-Out Meniscus Repair: Gaps in the Long-Term Current Evidence
by Cariane Driad, Maika Bazebi, David Mazy and Marie-Lyne Nault
Bioengineering 2026, 13(1), 62; https://doi.org/10.3390/bioengineering13010062 - 6 Jan 2026
Viewed by 1560
Abstract
Meniscal repair has become the preferred treatment for many meniscal tears. As a result, multiple arthroscopic techniques have evolved, including the all-inside (AI) and inside-out (IO) approaches, which have been widely studied in the current literature. The present article highlights key limitations in [...] Read more.
Meniscal repair has become the preferred treatment for many meniscal tears. As a result, multiple arthroscopic techniques have evolved, including the all-inside (AI) and inside-out (IO) approaches, which have been widely studied in the current literature. The present article highlights key limitations in studies reporting long-term outcomes (≥5 years), notably the heterogeneity of failure definitions and the lack of subgroup stratification by clinically relevant factors such as age, concomitant anterior cruciate ligament reconstruction (ACLR), and meniscal side (medial vs. lateral). To date, no clear superiority of the AI over the IO approach has been established. Redefining failure through multidimensional approaches that integrate structural, clinical, and patient-reported assessments will be crucial to ensure a consistent and patient-centered evaluation of repair success. Further research with robust subgroup analyses is needed to determine whether one technique confers superior long-term results in specific patient populations. Full article
(This article belongs to the Special Issue Novel Techniques in Meniscus Repair)
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