Background: The meniscus plays a crucial role in knee joint stability, load transmission, and stress distribution.\nMeniscal tears are the most common reported knee injuries, and the current standard treatment for meniscal\ndeficiency is meniscal allograft transplantation. A major limitation of this approach is that meniscal allografts do not\nhave the capacity to remodel and maintain tissue homeostasis due to a lack of cellular infiltration. The purpose of\nthis study was to provide a new method for enhanced cellular infiltration in meniscal allografts.\nMethods: Twenty medial menisci were collected from cadaveric human sources and split into five experimental groups:\n(1) control native menisci, (2) decellularized menisci, (3) decellularized menisci seeded with human adipose-derived stem\ncells (hASC), (4) decellularized needle-punched menisci, and (5) decellularized needle-punched menisci seeded with\nhASC. All experimental allografts were decellularized using a combined method with trypsin EDTA and peracetic acid.\nNeedle punching (1-mm spacing, 28 G microneedle) was utilized to improve porosity of the allograft. Samples were\nrecellularized with hASC at a density of 250 k/g of tissue. After 28 days of in vitro culture, menisci were analyzed for\nmechanical, biochemical, and histological characteristics.\nResults: Menisci maintained structural integrity and material properties (compressive equilibrium and dynamic moduli)\nthroughout preparations. Increased DNA content was observed in the needle-punched menisci but not in the samples\nwithout needle punching. Histology confirmed these results, showing enhanced cellular infiltration in needle-punched\nsamples.\nConclusions: The enhanced infiltration achieved in this study could help meniscal allografts better remodel post-surgery.\nThe integration of autologous adipose-derived stem cells could improve long-term efficacy of meniscal transplantation\nprocedures by helping to maintain the meniscus in vivo.
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