State of the Art for Meniscal Scaffolds

Meniscal damage increases contact stress to the underlying chondral surface, leading to cartilage degeneration. However, meniscal repair is not always feasible, and partial meniscectomy is still the current standard of care for irreparable symptomatic lesions, including failure of primary repair. This approach can lead to the development of early osteoarthritis and irreversible knee damage in the long term. The main goals for treating the post-meniscectomy deficient knee are to allow pain-free daily activities, prevent swelling, and avoid further joint degeneration. The concept of meniscal regeneration has become very appealing. This process requires a scaffold for successful migration and colonization with precursor cells and vessels, leading to the formation of organized new meniscal tissue. Two meniscal scaffolds are available: one is composed of aliphatic polyurethane named Actifit, and the other is based on collagen type I fibers called Collagen Meniscal Implant. Both provide an effective and safe solution for treating symptomatic patients with segmental mid-substance meniscus defects. Recent literature has demonstrated that scaffolds are effective both in mid- and long-term outcomes and significantly improve patient satisfaction and clinical evaluation; therefore, they are suggested for meniscus preservation and long-term knee health.