The potential of tendon autograft as meniscus substitution: Current concepts

Meniscectomy is known to alter the mechanics, stability, and kinematics of the tibiofemoral joint, leading to early knee osteoarthritis (KOA). While several meniscal substitutions exist, such as meniscus allograft transplantation, collagen meniscus implants, and artificial substitutes, they often come with technical challenges, high costs, and risks, including allograft failure, infections, and disease transmission. Tendon autografts emerge as a promising option, offering safety, availability, biocompatibility, and a reduced risk of pathophoresis. This review delves into basic, in vivo, in vitro, and biomechanical studies alongside clinical outcomes and future prospects of tendon autografts as meniscus substitutes. A thorough understanding of this option is vital for integrating these evolving techniques into clinical practice and mitigating early KOA progression.