Background: Considerable interindividual variation in meniscal microvascularization has been reported. The purpose of this review was to identify which patient characteristics affect meniscal... Show moreBackground: Considerable interindividual variation in meniscal microvascularization has been reported. The purpose of this review was to identify which patient characteristics affect meniscal microvascularization and provide a structured overview of angiogenic ther-apies that influence meniscal neovascularization.Methods: A systematic literature search was undertaken using PubMed, Embase, Web of Science, Cochrane library and Emcare from inception to November 2021. Studies reporting on (1) Patient characteristics that affect meniscal microvascularization, or (2) Therapies that induce neovascularization in meniscal tissue were included. Studies were graded in quality using the Anatomical Quality Assessment (AQUA) tool. The study was registered with PROSPERO(ID:CRD42021242479).Results: Thirteen studies reported on patient characteristics and eleven on angiogenic ther-apies. The influence of Age, Degenerative knee, Gender, and Race was reported. Age is the most studied factor. The entire meniscus is vascularized around birth. With increasing age, vascularization decreases from the inner to the peripheral margin. Around 11 years, blood vessels are primarily located in the peripheral third of the menisci. There seems to be a fur-ther decrease in vascularization with increasing age in adults, yet conflicting literature exists. Degenerative changes of the knee also seem to influence meniscal vascularization, but evidence is limited. Angiogenic therapies to improve meniscal vascularization have only been studied in preclinical setting. The use of synovial flap transplantation, stem cell therapy, vascular endothelial growth factor, and angiogenin has shown promising results.Conclusion: To decrease failure rates of meniscal repair, a better understanding of patient -specific vascular anatomy is essential. Translational clinical research is needed to investi-gate the clinical value of angiogenic therapies.(c) 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Show less
This thesis is about meniscal tears and repair in the first part and on meniscal allograft transplantation in the second part. An overview of meniscal function, effects of meniscal deficiency and ... Show moreThis thesis is about meniscal tears and repair in the first part and on meniscal allograft transplantation in the second part. An overview of meniscal function, effects of meniscal deficiency and (historical) treatment options are given.The first part is further focussed on meniscal reparability based on MRI findings and evaluates clinical survival of meniscal repair.The second part of this thesis is focuses on meniscal allograft transplantation. Clinical results of both open and arthroscopically assisted MAT are presented. A Dutch meniscal patient reported outcome measure (PROM)is translated and culturally adapted. Show less
