AccScience Publishing / IJB / Volume 9 / Issue 3 / DOI: 10.18063/ijb.693
Cite this article
Journal Browser
Volume | Year
News and Announcements
View All

Meniscus heterogeneity and 3D-printed strategies for engineering anisotropic meniscus

Ming-Ze Du Yun Dou Li-Ya Ai1 Tong Su1 Zhen Zhang1 You-Rong Chen1* Dong Jiang1*
Show Less
1 Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China
Submitted: 25 August 2022 | Accepted: 12 November 2022 | Published: 27 February 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

The meniscus is a fibrocartilaginous tissue of the knee joint that plays an important role in load transmission, shock absorption, joint stability maintenance, and contact stress reduction. Mild meniscal injuries can be treated with simple sutures, whereas severe injuries inevitably require meniscectomy. Meniscectomy destroys the mechanical microenvironment of the knee joint, leading to cartilage degeneration and osteoarthritis. Tissue engineering techniques, as a strategy with diverse sources and customizable and adjustable mechanical and biological properties, have emerged as promising approaches for the treatment of meniscal injuries and are represented by 3D printing. Notably, the heterogeneity of the meniscus, including its anatomical structure, cell phenotype, extracellular matrix, and biomechanical properties, is crucial for its normal function. Therefore, the construction of heterogeneous tissue-engineered menisci (TEM) has become a research hotspot in this field. In this review, we systematically summarize the heterogeneity of menisci and 3D-printed strategies for tissue-engineered anisotropic menisci. The manufacturing techniques, biomaterial combinations, surface functionalization, growth factors, and bioreactors related to 3D-printed strategies are introduced and a promising direction for the future research is proposed.

Tissue engineering
3D printing

1. Syed S, Zaki MN, Lakshmanan J, et al., 2022, Knee meniscal retears after repair: A systematic review comparing diagnostic imaging modalities. Libyan J Med, 17: 2030024. 

2. Gee SM, Posner M, 2021, Meniscus anatomy and basic science. Sports Med Arthrosc Rev, 29: e18–23. 

3. Canciani B, Millar VR, Pallaoro M, et al., 2021, Testing hypoxia in pig meniscal culture: Biological role of the vascular-related factors in the differentiation and viability of neonatal meniscus. Int J Mol Sci, 22: 12465. 

4. Logerstedt DS, Ebert JR, MacLeod TD, et al., 2022, Effects of and response to mechanical loading on the knee. Sports Med, 52: 201–235. 

5. Morejon A, Mantero AM, Best TM, et al., 2022, Mechanisms of energy dissipation and relationship with tissue composition in human meniscus. Osteoarthritis Cartilage, 30: 605–612. 

6. Hart DA, Nakamura N, Shrive NG, 2021, Perspective: Challenges presented for regeneration of heterogeneous musculoskeletal tissues that normally develop in unique biomechanical environments. Front Bioeng Biotechnol, 9: 760273.

7. Perrone D, 1946, Upon a case of right internal meniscus injur; meniscectomy. Med Cir Farm, 8: 20–23. 

8. Garrett WE Jr., Swiontkowski MF, Weinstein JN, et al., 2006, American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part-II, certification examination case mix. J Bone Joint Surg Am, 88: 660–667. 

9. Sheffield R, 1978, Community health education fostered by hospital program. Hospitals, 52: 113–114, 118–119. 

10. Brutico JM, Wright ML, Kamel SI, et al., 2021, The relationship between discoid meniscus and articular cartilage thickness: A quantitative observational study with MRI. Orthop J Sports Med, 9: 23259671211062256. 

11. Poulsen E, Goncalves GH, Bricca A, et al., 2019, Knee osteoarthritis risk is increased 4-6 fold after knee injury-a systematic review and meta-analysis. Br J Sports Med, 53: 1454–1463. 

12. Pattappa G, Johnstone B, Zellner J, et al., 2019, The importance of physioxia in mesenchymal stem cell chondrogenesis and the mechanisms controlling its response. Int J Mol Sci, 20: E484. 

13. Travascio F, Jackson AR, 2017, The nutrition of the human meniscus: A computational analysis investigating the effect of vascular recession on tissue homeostasis. J Biomech, 61: 151–159.
14. Di Giancamillo A, Deponti D, Modina S, et al., 2017, Age-related modulation of angiogenesis-regulating factors in the swine meniscus. J Cell Mol Med, 21: 3066–3075.

15. Monllau JC, Poggioli F, Erquicia J, et al., 2018, Magnetic resonance imaging and functional outcomes after a polyurethane meniscal scaffold implantation: Minimum 5-year follow-up. Arthroscopy, 34: 1621–1627. 

16. Houck DA, Kraeutler MJ, Belk JW, et al., 2018, Similar clinical outcomes following collagen or polyurethane meniscal scaffold implantation: A systematic review. Knee Surg Sports Traumatol Arthrosc, 26: 2259–2269. 

17. Perera K, Ivone R, Natekin E, et al., 2021, 3D bioprinted implants for cartilage repair in intervertebral discs and knee menisci. Front Bioeng Biotechnol, 9: 754113. 

18. Dai W, Wu T, Leng X, et al., 2021, Advances in biomechanical and biochemical engineering methods to stimulate meniscus tissue. Am J Transl Res, 13: 8540–8560. 

19. Kwon H, Brown WE, Lee CA, et al., 2019, Surgical and tissue engineering strategies for articular cartilage and meniscus repair. Nat Rev Rheumatol, 15: 550–570. 

20. Smith BD, Grande DA, 2015, The current state of scaffolds for musculoskeletal regenerative applications. Nat Rev Rheumatol, 11: 213–222. 

21. Makris EA, Hadidi P, Athanasiou KA, 2011, The knee meniscus: Structure-function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials, 32: 7411–7431. 

22. Wang H, Wang Z, Liu H, et al., 2021, Three-dimensional printing strategies for irregularly shaped cartilage tissue engineering: Current state and challenges. Front Bioeng Biotechnol, 9: 777039. 

23. Bryceland JK, Powell AJ, Nunn T, 2017, Knee menisci. Cartilage, 8: 99–104. 

24. Fox AJ, Bedi A, Rodeo SA, 2012, The basic science of human knee menisci: Structure, composition, and function. Sports Health, 4: 340–351. 

25. Li Q, Qu F, Han B, et al, 2017, Micromechanical anisotropy and heterogeneity of the meniscus extracellular matrix. Acta Biomater, 54: 356–366.
26. Han WM, Heo SJ, et al., 2016, Microstructural heterogeneity directs micromechanics and mechanobiology in native and engineered fibrocartilage. Nat Mater, 15: 477–484.
27. Leslie BW, Gardner DL, McGeough JA, et al., 2000, Anisotropic response of the human knee joint meniscus to unconfined compression. Proc Inst Mech Eng H, 214: 631–635. 

28. Coluccino L, Peres C, Gottardi R, et al., 2017, Anisotropy in the viscoelastic response of knee meniscus cartilage. J Appl Biomater Funct Mater, 15: e77–e83. 

29. Gardner E, O’Rahilly R, 1968, The early development of the knee joint in staged human embryos. J Anat, 102: 289–299. 

30. McDermott ID, Sharifi F, Bull AM, et al., 2004, An anatomical study of meniscal allograft sizing. Knee Surg Sports Traumatol Arthrosc, 12: 130–135. 

31. Shaffer B, Kennedy S, Klimkiewicz J, et al., 2000, Preoperative sizing of meniscal allografts in meniscus transplantation. Am J Sports Med, 28: 524–533. 

32. Clark CR, Ogden JA, 1983, Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am, 65: 538–547. 

33. Natsis K, Karasavvidis T, Kola D, et al., 2020, Meniscofibular ligament: How much do we know about this structure of the posterolateral corner of the knee: Anatomical study and review of literature. Surg Radiol Anat, 42: 1203–1208. 

34. Guy S, Ferreira A, Carrozzo A, et al., 2022, Isolated meniscotibial ligament rupture: The medial meniscus “Belt Lesion. ”Arthrosc Tech, 11: e133–e138. 

35. Arner JW, Ruzbarsky JJ, Vidal AF, et al., 2022, Meniscus repair part 1: Biology, function, tear morphology, and special considerations. J Am Acad Orthop Surg, 30: e852–e858. 

36. Gee SM, Posner M, 2021, Meniscus anatomy and basic science. Sports Med Arthrosc Rev, 29: e18–e23. 

37. Abbadessa A, Crecente-Campo J, Alonso MJ, 2021, Engineering anisotropic meniscus: Zonal functionality and spatiotemporal drug delivery. Tissue Eng Part B Rev, 27: 133–154. 

38. Williams LB, Adesida AB, 2018, Angiogenic approaches to meniscal healing. Injury, 49: 467–472. 

39. Roughley PJ, 2006, The structure and function of cartilage proteoglycans. Eur Cell Mater, 12: 92–101. 

40. Dye SF, Vaupel GL, Dye CC, 1998, Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med, 26: 773–777. 

41. Herwig J, Egner E, Buddecke E, 1984, Chemical changes of human knee joint menisci in various stages of degeneration. Ann Rheum Dis, 43: 635–640. 

42. Proctor CS, Schmidt MB, Whipple RR, et al., 1989, Material properties of the normal medial bovine meniscus. J Orthop Res, 7: 771–782. 

43. Sweigart MA, Athanasiou KA, 2001, Toward tissue engineering of the knee meniscus. Tissue Eng, 7: 111–129. 

44. McDevitt CA, Webber RJ, 1990, The ultrastructure and biochemistry of meniscal cartilage. Clin Orthop Relat Res, 252: 8–18. 

45. Miller GK, 1996, A prospective study comparing the accuracy of the clinical diagnosis of meniscus tear with magnetic resonance imaging and its effect on clinical outcome. Arthroscopy, 12: 406–413. 

46. Li H, Wang X, Liu J, et al., 2021, Nanofiber configuration affects biological performance of decellularized meniscus extracellular matrix incorporated electrospun scaffolds. Biomed Mater, 16: 065013. 

47. Ghadially FN, Lalonde JM, Wedge JH, 1983, Ultrastructure of normal and torn menisci of the human knee joint. J Anat, 136: 773–791. 

48. Ghadially FN, Thomas I, Yong N, 1978, Ultrastructure of rabbit semilunar cartilages. J Anat, 125: 499–517. 

49. Le Graverand MP, Ou Y, Schield-Yee T, et al., 2001, The cells of the rabbit meniscus: Their arrangement, interrelationship, morphological variations and cytoarchitecture. J Anatomy, 198: 525–535. 

50. Zhang X, Aoyama T, Ito A, et al., 2014, Regional comparisons of porcine menisci. J Orthop Res, 32: 1602–1611. 

51. Vanderploeg EJ, Wilson CG, Imler SM, et al., 2012, Regional variations in the distribution and colocalization of extracellular matrix proteins in the juvenile bovine meniscus. J Anat, 221: 174–186. 

52. Di Giancamillo A, Deponti D, Addis A, et al., 2014, Meniscus maturation in the swine model: Changes occurring along with anterior to posterior and medial to lateral aspect during growth. J Cell Mol Med, 18: 1964–1974. 

53. Zhang Z, Guo W, Gao S, et al., 2018, Native tissue-based strategies for meniscus repair and regeneration. Cell Tissue Res, 373: 337–350.

54. Pillai MM, Gopinathan J, Selvakumar R, et al., 2018, Human knee meniscus regeneration strategies: A review on recent advances. Curr Osteoporos Rep, 16: 224–235.
55. Seitz AM, Galbusera F, Krais C, et al., 2013, Stress-relaxation response of human menisci under confined compression conditions. J Mech Behav Biomed Mater, 26: 68–80.
56. Higashioka MM, Chen JA, Hu JC, et al., 20147, Building an anisotropic meniscus with zonal variations. Tissue Eng Part A, 20: 294–302. 

57. Ahmed AM, Burke DL, 1983, In-vitro measurement of static pressure distribution in synovial joints--part I: Tibial surface of the knee. J Biomech Eng, 105: 216–225. 

58. Shrive NG, O’Connor JJ, Goodfellow JW, 1978, Load-bearing in the knee joint. Clin Orthop Relat Res, 131: 279–287. 

59. Kurosawa H, Fukubayashi T, Nakajima H, 1980, Load-bearing mode of the knee joint: Physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res, 149, 283–290. 

60. Kawahara Y, Uetani M, Fuchi K, et al., 1999, MR assessment of movement and morphologic change in the menisci during knee flexion. Acta Radiol, 40: 610–614. 

61. Freutel M, Seitz AM, Galbusera F, et al., 2014, Medial meniscal displacement and strain in three dimensions under compressive loads: MR assessment: 3D Displacement and strain of the meniscus. J Magn Reson Imaging, 40: 1181–1188. 

62. Beaupré A, Choukroun R, Guidouin R, et al., 1986, Knee menisci. Correlation between microstructure and biomechanics. Clin Orthop Relat Res, 208: 72–75. 

63. Bullough PG, Munuera L, Murphy J, et al., 1970, The strength of the menisci of the knee as it relates to their fine structure. J Bone Joint Surg Br, 52: 564–567. 

64. Moyer JT, Priest R, Bouman T, et al., 2013, Indentation properties and glycosaminoglycan content of human menisci in the deep zone. Acta Biomater, 9: 6624–6629. 

65. Gonzalez-Leon EA, Hu JC, Athanasiou KA, 2022, Yucatan minipig knee meniscus regional biomechanics and biochemical structure support its suitability as a large animal model for translational research. Front Bioeng Biotechnol, 10: 844416. 

66. Skaggs DL, Warden WH, Mow VC, 1994, Radial Tie fibers influence the tensile properties of the bovine medial meniscus. J Orthop Res, 12: 176–185. 

67. Joshi MD, Suh JK, Marui T, et al., 1995, Interspecies variation of compressive biomechanical properties of the meniscus. J Biomed Mater Res, 29: 823–828. 

68. Danso EK, Mäkelä JT, Tanska P, et al., 2015, Characterization of site-specific biomechanical properties of human meniscus-importance of collagen and fluid on mechanical nonlinearities. J Biomech, 48: 1499–1507. 

69. Berni M, Marchiori G, Cassiolas G, et al., 2021, Anisotropy and inhomogeneity of permeability and fibrous network response in the pars intermedia of the human lateral meniscus. Acta Biomater, 135: 393–402. 

70. Upton ML, Hennerbichler A, Fermor B, et al., 2006, Biaxial strain effects on cells from the inner and outer regions of the meniscus. Connect Tissue Res, 47: 207–214. 

71. Furumatsu T, Kanazawa T, Miyake Y, et al., 2012, Mechanical stretch increases Smad3-dependent CCN2 expression in inner meniscus cells: Stretch-induced CCN2 in the meniscus. J Orthop Res, 30: 1738–1745. 

72. Guo W, Liu S, Zhu Y, et al., 2015, Advances and prospects in tissue-engineered meniscal scaffolds for meniscus regeneration. Stem Cells Int, 2015: 517520. 

73. Vasiliadis AV, Koukoulias N, Katakalos K, 2021, Three-dimensional-printed scaffolds for meniscus tissue engineering: Opportunity for the future in the orthopaedic world. J Funct Biomater, 12: 69. 

74. Yang Y, Chen Z, Song X, et al., 2017, Biomimetic anisotropic reinforcement architectures by electrically assisted nanocomposite 3D printing. Adv Mater, 29: 1605750. 

75. Bahcecioglu G, Bilgen B, Hasirci N, et al., 2019, Anatomical meniscus construct with zone specific biochemical composition and structural organization. Biomaterials, 218: 119361.

76. Din US, Sian TS, Deane CS, et al., 2021, Green tea extract concurrent with an oral nutritional supplement acutely enhances muscle microvascular blood flow without altering leg glucose uptake in healthy older adults. Nutrients, 13: 3895. 

77. Terpstra ML, Li J, Mensinga A, et al., 2022, Bioink with cartilage-derived extracellular matrix microfibers enables spatial control of vascular capillary formation in bioprinted constructs. Biofabrication, 14: 034104. 

78. Kumar G, Tison CK, Chatterjee K, et al., 2011, The determination of stem cell fate by 3D scaffold structures through the control of cell shape. Biomaterials, 32: 9188–9196. 

79. Neffe AT, Pierce BF, Tronci G, et al., 2015, One step creation of multifunctional 3D architectured hydrogels inducing bone regeneration. Adv Mater, 27: 1738–1744. 

80. Zhang ZZ, Jiang D, Ding JX, et al., 2016, Role of scaffold mean pore size in meniscus regeneration. Acta Biomater, 43: 314–326. 

81. Di Luca A, Szlazak K, Lorenzo-Moldero I, et al., 2016, Influencing chondrogenic differentiation of human mesenchymal stromal cells in scaffolds displaying a structural gradient in pore size. Acta Biomater, 36: 210–219. 

82. van der Wal WA, Meijer DT, Hoogeslag RA, et al., 2022, Meniscal tears, posterolateral and posteromedial corner injuries, increased coronal plane, and increased sagittal plane tibial slope all influence anterior cruciate ligament-related knee kinematics and increase forces on the native and reconstructed anterior cruciate ligament: A Systematic review of cadaveric studies. Arthroscopy, 38: 1664–1688.e1. 

83. Stocco TD, Silva MC, Corat MA, et al., 2022, Towards bioinspired meniscus-regenerative scaffolds: Engineering a novel 3D bioprinted patient-specific construct reinforced by biomimetically aligned nanofibers. Int J Nanomed, 17: 1111–1124.
84. Cengiz IF, Maia FR, da Silva Morais A, et al., 2020, Entrapped in cage (EiC) scaffolds of 3D-printed polycaprolactone and porous silk fibroin for meniscus tissue engineering. Biofabrication, 12: 025028. 

85. Li H, Li P, Yang Z, et al., 2021, Meniscal regenerative scaffolds based on biopolymers and polymers: Recent status and applications. Front Cell Dev Biol, 9: 661802. 

86. Bahcecioglu G, Hasirci N, Bilgen B, et al., 2019, A 3D printed PCL/hydrogel construct with zone-specific biochemical composition mimicking that of the meniscus. Biofabrication, 11: 025002. 

87. Romanazzo S, Vedicherla S, Moran C, et al., 2018, Meniscus ECM-functionalised hydrogels containing infrapatellar fat pad-derived stem cells for bioprinting of regionally defined meniscal tissue. J Tissue Eng Regen Med, 12: e1826–e1835. 

88. Li H, Liao Z, Yang Z, et al., 2021, 3D printed poly(ε- caprolactone)/meniscus extracellular matrix composite scaffold functionalized with kartogenin-releasing PLGA microspheres for meniscus tissue engineering. Front Bioeng Biotechnol, 9: 662381. 

89. Hao L, Tianyuan Z, Zhen Y, et al., 2021, Biofabrication of cell-free dual drug-releasing biomimetic scaffolds for meniscal regeneration. Biofabrication, 14: 015001. 

90. Gomes JM, Silva SS, Fernandes EM, et al., 2022, Silk fibroin/ cholinium gallate-based architectures as therapeutic tools. Acta Biomater, 147: 168–184. 

91. Yu Q, Han F, Yuan Z, et al., 2022, Fucoidan-loaded nanofibrous scaffolds promote annulus fibrosus repair by ameliorating the inflammatory and oxidative microenvironments in degenerative intervertebral discs. Acta Biomater, 148: 73–89. 

92. Xu B, Ye J, Fan BS, et al., 2023, Protein-spatiotemporal partition releasing gradient porous scaffolds and anti-inflammatory and antioxidant regulation remodel tissue engineered anisotropic meniscus. Bioact Mater, 20: 194–207. 

93. Lammel AS, Hu X, Park SH, et al., 2010, Controlling silk fibroin particle features for drug delivery. Biomaterials, 31: 4583–4591.
94. Gou S, Chen N, Wu X, et al., 2022, Multi-responsive nanotheranostics with enhanced tumor penetration and oxygen self-producing capacities for multimodal synergistic cancer therapy. Acta Pharm Sin B, 12: 406–423. 

95. Li Z, Wu N, Cheng J, et al., 2020, Biomechanically, structurally and functionally meticulously tailored polycaprolactone/ silk fibroin scaffold for meniscus regeneration. Theranostics, 10: 5090–5106. 

96. Pillai MM, Gopinathan J, Kumar RS, et al., 2018, Tissue engineering of human knee meniscus using functionalized and reinforced silk-polyvinyl alcohol composite three-dimensional scaffolds: Understanding the in vitro and in vivo behavior. J Biomed Mater Res A, 106: 1722–1731. 

97. Spang MT, Christman KL, 2018, Extracellular matrix hydrogel therapies: In vivo applications and development. Acta Biomater, 68: 1–14.
98. Hu X, Xia Z, Cai K, 2022, Recent advances in 3D hydrogel culture systems for mesenchymal stem cell-based therapy and cell behavior regulation. J Mater Chem B, 10: 1486–1507. 

99. Yu Z, Lili J, Tiezheng Z, et al., 2019, Development of decellularized meniscus extracellular matrix and gelatin/ chitosan scaffolds for meniscus tissue engineering. Biomed Mater Eng, 30: 125–132. 

100. Gao S, Guo W, Chen M, et al., 2017, Fabrication and characterization of electrospun nanofibers composed of decellularized meniscus extracellular matrix and polycaprolactone for meniscus tissue engineering. J Mater Chem B, 5: 2273–2285.
101. Shimomura K, Rothrauff BB, Tuan RS, 2017, Region-specific effect of the decellularized meniscus extracellular matrix on mesenchymal stem cell-based meniscus tissue engineering. Am J Sports Med, 45: 604–611. 

102. Gao S, Yuan Z, Guo W, et al., 2017, Comparison of glutaraldehyde and carbodiimides to crosslink tissue engineering scaffolds fabricated by decellularized porcine menisci. Mater Sci Eng C Mater Biol Appl, 71: 891–900. 

103. Sun Y, Zhang Y, Wu Q, et al., 2021, 3D-bioprinting ready-to-implant anisotropic menisci recapitulate healthy meniscus phenotype and prevent secondary joint degeneration. Theranostics, 11: 5160–5173. 

104. Xia B, Kim DH, Bansal S, et al., 2021, Development of a decellularized meniscus matrix-based nanofibrous scaffold for meniscus tissue engineering. Acta Biomater, 128: 175–185. 

105. Wu J, Xu J, Huang Y, et al., 2021, Regional-specific meniscal extracellular matrix hydrogels and their effects on cell-matrix interactions of fibrochondrocytes. Biomed Mater, 17: 014105.
106. Zhong G, Yao J, Huang X, et al., 2020, Injectable ECM hydrogel for delivery of BMSCs enabled full-thickness meniscus repair in an orthotopic rat model. Bioact Mater, 5: 871–879. 

107. Guo W, Chen M, Wang Z, et al., 2021, 3D-printed cell-free PCL-MECM scaffold with biomimetic micro-structure and micro-environment to enhance in situ meniscus regeneration. Bioact Mater, 6: 3620–3633. 

108. Vassiliou G, 1986, Current concepts of cervical fractures of the teeth and their treatment. Stomatologia (Athenai), 43: 399–411. 

109. Rothrauff BB, Shimomura K, Gottardi R, et al., 2017, Anatomical region-dependent enhancement of 3-dimensional chondrogenic differentiation of human mesenchymal stem cells by soluble meniscus extracellular matrix. Acta Biomater, 49: 140–151. 

110. Zhang CY, Fu CP, Li XY, et al., 2022, Three-dimensional bioprinting of decellularized extracellular matrix-based bioinks for tissue engineering. Molecules, 27: 3442. 

111. Szojka A, Lalh K, Andrews SH, et al., 2017, Biomimetic 3D printed scaffolds for meniscus tissue engineering. Bioprinting, 8: 1–7. 

112. Sooriyaarachchi D, Wu J, Feng A, et al., 2019, Hybrid fabrication of biomimetic meniscus scaffold by 3D printing and parallel electrospinning. Proc Manuf, 34: 528–534. 

113. Lan X, Ma Z, Szojka AR, et al., 2021, TEMPO-oxidized cellulose nanofiber-alginate hydrogel as a bioink for human meniscus tissue engineering. Front Bioeng Biotechnol, 9: 766399. 

114. Costa JB, Park J, Jorgensen AM, et al., 2020, 3D bioprinted highly elastic hybrid constructs for advanced fibrocartilaginous tissue regeneration. Chem Mater, 32: 8733–8746. 

115. Jian Z, Zhuang T, Qinyu T, et al., 2021, 3D bioprinting of a biomimetic meniscal scaffold for application in tissue engineering. Bioact Mater, 6: 1711–1726. 

116. Gupta S, Sharma A, Kumar JV, et al., 2020, Meniscal tissue engineering via 3D printed PLA monolith with carbohydrate based self-healing interpenetrating network hydrogel. Int J Biol Macromol, 162: 1358–13571. 

117. Deng X, Chen X, Geng F, et al., 2021, Precision 3D printed meniscus scaffolds to facilitate hMSCs proliferation and chondrogenic differentiation for tissue regeneration. J Nanobiotechnology, 19: 400. 

118. Zhou ZX, Chen YR, Zhang JY, et al., 2020, Facile strategy on hydrophilic modification of poly(ε-caprolactone) scaffolds for assisting tissue-engineered meniscus constructs in vitro. Front Pharmacol, 11: 471. 

119. Rodeo SA, Monibi F, Dehghani B, et al., 2020, Biological and mechanical predictors of meniscus function: Basic science to clinical translation. J Orthop Res, 38: 937–945. 

120. Mononen ME, Jurvelin JS, Korhonen RK, 2013, Effects of radial tears and partial meniscectomy of lateral meniscus on the knee joint mechanics during the stance phase of the gait cycle--a 3D finite element study. J Orthop Res, 31: 1208–1217. 

121. Halonen KS, Mononen ME, Jurvelin JS, et al., 2014, Deformation of articular cartilage during static loading of a knee joint--experimental and finite element analysis. J Biomech, 47: 2467–2474. 

122. Khoshgoftar M, Torzilli PA, Maher SA, 2018, Influence of the pericellular and extracellular matrix structural properties on chondrocyte mechanics. J Orthop Res, 36: 721–729. 

123. Yang N, Nayeb-Hashemi H, Canavan PK, 2009, The combined effect of frontal plane tibiofemoral knee angle and meniscectomy on the cartilage contact stresses and strains. Ann Biomed Eng, 37: 2360–2372. 

124. Peña E, Calvo B, Martínez MA, et al., 2005, Finite element analysis of the effect of meniscal tears and meniscectomies on human knee biomechanics. Clin Biomech (Bristol, Avon), 20: 498–507. 

125. Scotti C, Hirschmann MT, Antinolfi P, et al., 2013, Meniscus repair and regeneration: Review on current methods and research potential. Eur Cell Mater, 26: 150–170. 

126. Zhang ZZ, Chen YR, Wang SJ, et al., 2019, Orchestrated biomechanical, structural, and biochemical stimuli for engineering anisotropic meniscus. Sci Transl Med, 11: eaao0750. 

127. Longobardi L, O’Rear L, Aakula S, et al., 2006, Effect of IGF-I in the chondrogenesis of bone marrow mesenchymal stem cells in the presence or absence of TGF-beta signaling. J Bone Miner Res, 21: 626–636. 

128. Worster AA, Nixon AJ, Brower-Toland BD, et al., 2000, Effect of transforming growth factor beta1 on chondrogenic differentiation of cultured equine mesenchymal stem cells. Am J Vet Res, 61: 1003–1010. 

129. Lee CH, Shah B, Moioli EK, et al., 2015, CTGF directs fibroblast differentiation from human mesenchymal stem/ stromal cells and defines connective tissue healing in a rodent injury model. J Clin Invest, 125: 3992. 

130. Furumatsu T, Kanazawa T, Miyake Y, et al., 2012, Mechanical stretch increases Smad3-dependent CCN2 expression in inner meniscus cells. J Orthop Res, 30: 1738–1745. 

131. Lee CH, Rodeo SA, Fortier LA, et al., 2014, Protein-releasing polymeric scaffolds induce fibrochondrocytic differentiation of endogenous cells for knee meniscus regeneration in sheep. Sci Transl Med, 6: 266ra171. 

132. Nakagawa Y, Fortier LA, Mao JJ, et al., 2019, Long-term evaluation of meniscal tissue formation in 3-dimensional-printed scaffolds with sequential release of connective tissue growth factor and TGF-β3 in an ovine model. Am J Sports Med, 47: 2596–25607.

Back to top
International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing