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RESEARCH ARTICLE

The Design and Characterization of a Strong Bio-Ink for

Meniscus Regeneration

Jingwei Lu , Jianhao Huang , Jing Jin , Chunmei Xie , Bin Xue , Jiancheng Lai , Biao Cheng *,
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Lan Li *, Qing Jiang 3,8
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1 Department of Orthopedics, Jinling School of Clinical Medicine, Nanjing Medical University, Jinling Hospital, Nanjing, China
2 Department of Orthopedics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China
3 State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery,
Department of Orthopedic Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing, China
4 Hangzhou Lancet Robotics Company Ltd, Hangzhou, China
5 National Laboratory of Solid State Microstructures, Department of Physics, Nanjing University, Nanjing, China
6 Department of Chemical Engineering, Stanford University, Stanford, United States
7 Department of Orthopaedics, Shanghai Tenth People’s Hospital, School of Clinical Medicine, Nanjing Medical University,
Shanghai, China
8 Jiangsu Engineering Research Center for 3D Bioprinting, Nanjing, China
Abstract: The meniscus is vital to the mechanical function of the knee, while it is frequently harmed because it bears a heavy
load. A strong bio-ink for meniscus regeneration was prepared for the future meniscal tissue engineering. The prepared bio-
ink consists of poly (vinyl alcohol) and decellularized extracellular matrix (PVA/dECM). The mechanical properties and
the rheological features were explored to evaluate the effects of freezing/thawing cycles and alkaline treatment process. The
printability was verified using a three-dimensional printer. The endothelial cells were employed to assess the biocompatibility.
Finally, a 12-week rabbit meniscus defect model was established to evaluate the meniscus regeneration capability. We found
that the bio-ink by soaking in alkaline for 40 min and 20 freezing/thawing cycles demonstrated excellent mechanical properties.
The Young’s modulus reached 0.49 MPa and the stress limitation was 2.9 MPa. The results also showed good printability
and biocompatibility of the proposed bio-ink in vitro. The PVA/dECM hydrogel healed the meniscus defect after 12 weeks of
implantation. The articular cartilage and subchondral bone exhibited normal microstructure and composition. These results
suggested that the PVA/dECM hydrogel could be a promising solution to repair meniscal lesions with preventive effects
against degenerative meniscal tears and post-traumatic arthritis.
Keywords: Meniscus; 3D printing; Strong bio-ink; Tissue regeneration; Decellularized extracellular matrix

*Correspondence to: Lan Li, State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery,
Department of Orthopedic Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China; lanl17@163.com
Biao Cheng, Department of Orthopaedics, Shanghai Tenth People’s Hospital, School of Clinical Medicine, Nanjing Medical University, No. 301
Middle Yanchang Road, Shanghai 200072, China; biaocheng021@163.com

Received: April 11, 2022; Accepted: May 27, 2022; Published Online: August 8, 2022
(This article belongs to the Special Issue: Mechanical Behaviors of 3D/4D Printing Biomaterials and Smart Structures)
Citation: Lu J, Huang J, Jin J, et al., 2022, The Design and Characterization of a Strong Bio-Ink for Meniscus Regeneration. Int J Bioprint,
8(4):600. http://doi.org/10.18063/ijb.v8i4.600

1. Introduction joint. Load transfer to a vast region of articular cartilage,
The menisci in the knee are two crescent-shaped joint stability, and shock absorption during dynamic
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fibrocartilage discs positioned between the femur and tibia motions are the fundamental roles of the menisci . The
surfaces in the medial and lateral compartments of the meniscus is important for maintaining the knee joint’s
© 2022 Author(s). This is an Open-Access article distributed under the terms of the Creative Commons Attribution License, permitting distribution and
reproduction in any medium, provided the original work is properly cited.
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