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International Journal of Bioprinting 3D-printed anistropic meniscus

4. Conclusion Conflict of interest

Meniscus tears are one of the most common injuries in The authors declare that the research was conducted in the
sports medicine and can lead to pain, swelling, locking, absence of any commercial or financial relationships that
and movement disorders of the knee joint. For meniscus could be construed as potential conflicts of interest.
tear, although a few cases can be sutured, partial or total
meniscectomy is still the main treatment method, which will Author contributions
significantly increase the risk of osteoarthritis. Allogeneic Conceptualization: Dong Jiang, You-Rong Chen
meniscus transplantation can improve joint function Formal analysis: Li-Ya Ai, Tong Su, Zhen Zhang.Writing –
and relieve symptoms such as pain and swelling after original draft: Ming-Ze Du, Yun Dou
meniscectomy, but there are still many limitations, such as Writing – review and editing: You-Rong Chen, Dong Jiang
insufficient donor source, potential immune rejection, and
uncertain long-term follow-up efficacy. Meniscus prostheses, All authors approved the final version for publication.
such as CMI , Actifit , and NUSurface , although applied Ethics approval and consent to participate
®
®
®
clinically, do not work well in long-term implantation. TEM
has become an emerging strategy to overcome this challenge Not applicable.
and 3D printing is a promising strategy due to its efficacy,
cost-effectiveness, controllability, and diversity of selectable Consent for publication
materials. Novel manufacturing techniques that combine Not applicable.
multiple biomaterials and apply bioreactors, 3D bioprinting,
surface functionalization, and growth factors are effective Availability of data
ways to realize the heterogeneity of TEM. All data that support the findings of this work are included
However, there are still some challenges and limitations within the article.
in terms of the meniscus tissue engineering strategies.
As discussed before, the meniscus is a fibrocartilaginous References
tissue within the knee joint and performs several 1. Syed S, Zaki MN, Lakshmanan J, et al., 2022, Knee meniscal
critical biofunctions, preventing the knee joint cartilage retears after repair: A systematic review comparing
degeneration. These crucial biofunctions were largely diagnostic imaging modalities. Libyan J Med, 17: 2030024.
generated by the special heterogeneity of natural meniscus, https://doi.org/10.1080/19932820.2022.2030024
including biological and biomechanical heterogeneities.
Therefore, the functional meniscus reconstruction is essential 2. Gee SM, Posner M, 2021, Meniscus anatomy and basic
science. Sports Med Arthrosc Rev, 29: e18–23.
for the successful cartilage protection and alleviation of knee
joint osteoarthritis. However, the current tissue engineering https://doi.org/10.1097/jsa.0000000000000327
approaches of meniscus reconstruction still cannot 3. Canciani B, Millar VR, Pallaoro M, et al., 2021, Testing
concurrently realize the biological and biomechanical hypoxia in pig meniscal culture: Biological role of the
reconstruction, so the meniscus biofunctions in the knee vascular-related factors in the differentiation and viability of
joint cannot be restored and the osteoarthritis induced by neonatal meniscus. Int J Mol Sci, 22: 12465.
meniscus injury cannot be alleviated consequently. Thus, https://doi.org/10.3390/ijms222212465
in future research concerning TEM, scientists should
take the biofunction restoration of natural meniscus into 4. Logerstedt DS, Ebert JR, MacLeod TD, et al., 2022, Effects
of and response to mechanical loading on the knee. Sports
consideration, instead of reconstructing the meniscus with Med, 52: 201–235.
biological and biomechanical heterogeneities separately.
In addition, considering the clinical promotion of the https://doi.org/10.1007/s40279-021-01579-7
TEM products, the practicability, simplicity, safety, and 5. Morejon A, Mantero AM, Best TM, et al., 2022, Mechanisms
functionality of that still need to be further explored. of energy dissipation and relationship with tissue
composition in human meniscus. Osteoarthritis Cartilage,
Funding 30: 605–612.
The authors would like to acknowledge financial support https://doi.org/10.1016/j.joca.2022.01.001
from the National Key Research and Development Program 6. Hart DA, Nakamura N, Shrive NG, 2021, Perspective:
of China (Grant No. 2019YFB1706900), National Natural Challenges presented for regeneration of heterogeneous
Science Foundation of China (82102565, 82072428), and musculoskeletal tissues that normally develop in unique
Natural Science Foundation of Beijing Municipality (7212132). biomechanical environments. Front Bioeng Biotechnol,

Volume 9 Issue 3 (2023) 372 https://doi.org/10.18063/ijb.693