Meniscal Replacement - Allograft Implantation and Synthetic Substitution [Verdonk- CIC Edizioni Internazionali]

In recent history clinicians have become aware of the importance of joint homeostasis and the meniscus. The human meniscus is a highly complex tissue with very specific characteristics on biological and biomechanical fields. This is still not very well understood. In order to replace this lost valuable tissue different approaches and techniques have been tried. These can be categorized in three groups: (1) replacement by human tissue as meniscus allografts, quadriceps tendon, Hoffa fat pad etc.; (2) replacement by prosthetic devices; and (3) substitution by developed tissue based on scaffolds, cells and growth factors, or a combination of these. Most physicians see the substitution of the meniscus as a valuable therapeutic option in the treatment of the (sub)total meniscectomized knee. A large clinical need supports further exploration of meniscal substitution. The several options are currently investigated. The biggest challenge being biology as in the prosthetic field the optimal material still has to be developed. This work looks into those issues and brings up to date information and new approaches that may help in the treatment of this complex pathology and the young and active population presenting with those symptoms.