title: Current advances in the development of natural meniscus scaffolds: innovative approaches to decellularization and recellularization.
abstract: The increasing rate of injuries to the meniscus indicates the urgent need to develop effective repair strategies. Irreparably damaged menisci can be replaced and meniscus allografts represent the treatment of choice; however, they have several limitations, including availability and compatibility. Another approach is the use of artificial implants but their chondroprotective activities are still not proved clinically. In this situation, tissue engineering offers alternative natural decellularized extracellular matrix (ECM) scaffolds, which have shown biomechanical properties comparable to those of native menisci and are characterized by low immunogenicity and promising regenerative potential. In this article, we present an overview of meniscus decellularization methods and discuss their relative merits. In addition, we comparatively evaluate cell types used to repopulate decellularized scaffolds and analyze the biocompatibility of the existing experimental models. At present, acellular ECM hydrogels, as well as slices and powders, have been explored, which seems to be promising for partial meniscus regeneration. However, their inferior biomechanical properties (compressive and tensile stiffness) compared to natural menisci should be improved. Although an optimal decellularized meniscus scaffold still needs to be developed and thoroughly validated for its regenerative potential in vivo, we believe that decellularized ECM scaffolds are the future biomaterials for successful structural and functional replacement of menisci.
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Yunbin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Kangliang
authors.initials: K
authors.lastname: Lou
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Shengyu
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.|Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Jinhu
authors.initials: J
authors.lastname: Ni
authors.affiliation: Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
authors.forename: Wenyue
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China. shunwu_fan@126.com.
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
authors.affiliation: Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China. xianfeng_lin@zju.edu.cn.
authors.forename: Xianfeng
authors.initials: X
authors.lastname: Lin
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D005109:Extracellular Matrix / Q000737:chemistry*; D006801:Humans; D020100:Hydrogels / Q000737:chemistry; D000072600:Meniscus / Q000737:chemistry* / Q000166:cytology / Q000502:physiology*; D012038:Regeneration; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds / Q000737:chemistry*
chemical_list: D001672:Biocompatible Materials; D020100:Hydrogels
keywords: Biomechanical properties; Decellularization; Extracellular matrix; Meniscus; Recellularization