A novel composite meniscus scaffold with shape memory and adhesive properties alleviates knee cartilage degeneration through minimally invasive and sutureless approach
Wenqiang Yan, Feng Tian, Lingyu Zhao, Pengyi Wang, Manwen Zhang, Zeyuan Gao, Wei Huang, Yingfang Ao, Ran Yu
Abstract
Three-dimensionally (3D) printed engineered meniscus scaffolds offer a promising therapeutic strategy for post-meniscectomy defects. Nevertheless, existing scaffolds face critical limitations impeding clinical implementation. Primarily, the transplantation procedure necessitates larger incisions in skin and joint capsules due to insufficient scaffold deformability. This invasive approach risks iatrogenic tissue damage, prolongs recovery timelines, and compromises aesthetic outcomes. Secondly, conventional fixation methods involving sutures to peripheral meniscal remnants or capsular tissues introduce dual complications: mechanical perforation of scaffolds reduces structural integrity and accelerates degradation, while the demanding technical requirements for suture placement increase surgical complexity. To address these challenges, we engineered a composite meniscus scaffold featuring an elastomeric skeleton fabricated via digital light processing (DLP) 3D printing integrated with a hydrogel matrix. This biomimetic design recapitulates the native meniscus architecture comprising an aqueous extracellular matrix reinforced by collagen fibrils. The composite scaffold demonstrates three critical functional attributes: 1) biomechanical properties approximating native meniscus tissue, 2) exceptional shape recovery capabilities facilitating trans-arthroscopic delivery through minimally invasive portals, and 3) strong interfacial adhesion enabling suture-free fixation via covalent bonding to host tissues. In vivo evaluation using a rabbit meniscectomy model confirmed the scaffold’s chondroprotective efficacy. Notably, preclinical validation in an ex vivo ovine knee under arthroscopic guidance demonstrated successful scaffold deployment through subcentimeter incisions with stable adhesion to residual meniscal tissue. This innovative design eliminates suture-related complications while reducing surgical invasiveness, thereby presenting a clinically translatable solution for irreparable meniscal injuries.