Experimental and Computational Approaches in Meniscus Mechanics and Mechanobiology

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Background

The menisci of the knee are fibrocartilaginous tissues that guarantee joint congruency, facilitate load transmission, and allow for load dampening. They manage to accomplish these functions through their unique semilunar wedged shape, which allows a congruent sliding of femur and tibia. Their structure is characterized by heterogeneous, anisotropic, nonlinear mechanical properties which allow them to withstand loads as high as multiple times the individual body weight.

Nevertheless, injuries to menisci are among the most prevalent in active population. Besides traumatically induced structural damage, ageing and/or osteoarthritis contribute to the inevitable process of meniscal degeneration. Different interventions are available to address meniscus pathologies, ranging from conservative treatments to (minimally) invasive surgeries including total/partial removal and/or replacement of the injured tissue. However, assessing the entity of tissue damage, the progression of the disease, and the efficacy of the treatments administered on the biomechanics of the meniscus are not easy tasks. This is due to the uniquely complex mechanobiological environment of the knee and the convolute relationship among tissue structure, composition, mechanical properties, and cellular population.

Knee simulators are available to mimic physiologically relevant mechanical loading on the meniscus, but they are limited in that they can only test cadaveric tissue. Also, animal models may overcome the limitations of a cadaveric tissue but are more difficult to control and are limited in their representation of human meniscal pathophysiology. Nevertheless, both approaches are invaluable to validate the outputs of computational models and to increase their credibility for clinical applications.

Computational models can be used to evaluate the biomechanics of the meniscus in healthy subjects, but also in patients with traumatic meniscal tears or during disease progression such as osteoarthritis. Further, medical conditions such as partial/total meniscectomy or sutures meniscus tears might be modeled with the aim to optimize the potential treatments. However, before their clinical application, they should go through a strict process for increasing their credibility, based on model verification, validation, and sensitivity analyses. There are several research challenges that need to be overcome to identify the best modeling strategies for studying meniscal biomechanics, for example:

- Evaluation of load distribution under different occupational activities;
- Animal models investigating treatments (surgical and/or pharmacological)
- Structural modeling approaches of experimental methods to evaluate the mechanical interactions between fiber and matrix the mechanical properties of different regions of the tissue;
- Mechanobiological approaches studying tissue homeostasis, degeneration, or regeneration in in-vitro or in-vivo scenarios;
- Cell-tissue level models (experimental or computational) to predict the evolution of the disease and pharmacological interventions on the health of the tissue;
- Generalized models for analyses of population data versus subject-specific models based on detailed medical images for the personalization of treatments;
- Artificial intelligence (AI) based models for diagnostics, prevention, and treatment

This Research Topic aims to attract Methods, Original Research, and Review papers from worldwide specialists in meniscus biomechanics and mechanobiology. It will offer a unique collection of knowledge and discussions for the improvement or the development of new approaches for studying the biomechanics and mechanobiology of the meniscus.

Keywords: Injury, Meniscal Tears, Fibrocartilage, Artificial Intelligence, Imaging, Computational Modeling, Mechanical Properties, Tissue Culture

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