Meniscal tissue engineering: Bridging clinical needs and experimental innovation

Meniscal injuries significantly impact knee function and pose clinical challenges globally. Conservative treatment and surgery are currently the more commonly used treatments, and there are still long-term joint problems such as incomplete meniscus healing and knee pain. Tissue engineering presents a promising alternative by using biomaterials, cellular therapies, and bioactive factors to repair meniscal damage. Despite the promising preclinical results, clinical applications still face challenges such as insufficient biomechanical strength, weak regenerative ability, or low durability. This review seeks to bridge clinical needs with engineering strategies by providing a comprehensive understanding of meniscal structure and function, as well as current treatments and their limitations. We aim to offer new insights to support the development of meniscus products in tissue engineering, thereby helping to lay a theoretical foundation for more accessible therapeutic solutions. Furthermore, we summarize recent advances in meniscus product research from both material and manufacturing perspectives within our laboratory. The translational potential of this article This review begins with an analysis of the macroscopic and microscopic structural characteristics of the meniscus, elucidating its critical physiological functions, thereby laying a theoretical foundation for the development of innovative meniscal repair strategy and providing structural design guidance for the construction of biomimetic meniscus. Subsequently, this review comprehensively summarizes the pathological characteristics of degenerative and traumatic tears, systematically evaluating the advantages and disadvantages of existing therapeutic approaches. Based on current clinical realities, it identifies treatment bottlenecks and unmet needs, offering reference points for research designs aligned with clinical requirements; addressing these problems specifically facilitates the translation of scientific findings into clinical products. Further, the review outlines the properties and manufacturing technologies of biomaterials, systematically comparing their performance in meeting the mechanical strength and functional demands of human meniscus, thus providing empirical references for material selection and fabrication techniques in next-generation product development. Finally, the review discusses the prospects and challenges of tissue engineering in meniscal therapy, aiming to enhance meniscal repair outcomes and provide personalized treatment protocols for patients with varying types of injuries.