Advances in bioadhesives for meniscal repair: A comprehensive review and criteria for the ideal candidate.

ABSTRACT

The latest studies agree that meniscal tears that require surgery should be repaired whenever possible to avoid early-onset osteoarthritis secondary to meniscectomy. Unfortunately, there are several limitations associated with meniscal sutures, making it difficult to put into practice the theory behind the concept of saving the meniscus. Meanwhile, there is an exponential growth in the use of tissue adhesives for surgery, but finding one suited to meniscal repair remains a struggle. This review has two main goals (1) to compile the various bioadhesives used in this field and (2) to list the criteria for an ideal meniscal bioadhesive. The review was conducted in PubMed, Google Scholar, and Web of Science in November 2023 without date restrictions. The inclusion criteria were Studies published in English and focusing on meniscal repair using bioadhesives. The exclusion criteria were Studies published in languages other than English. Adhesives used in combination with sutures, as the aim was to determine the adhesive's capabilities for meniscal repair alone. Synthetic adhesives such as polycyanoacrylates, polyethylene glycol, polyurethanes, and polyesters. Among the 11 bioadhesives found, fibrin is the only one that has been studied in humans. There are advantages and disadvantages to all the bioadhesives identified but none that fully meet the requirements for meniscal repair. The anatomy of meniscal tissue is complex and poses unique challenges that are compounded by arthroscopic stresses. The future of meniscal repair probably lies in combining the advantages of several bioadhesives, and this area should be the focus of future research.