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Understanding the structure of the meniscus and its process of repair has been critical in advancing surgical techniques and increasing healing rates following meniscal repair. Knowledge of the circumferential orientation of the collagen fibers has lead to the preferred position of sutures—vertical mattress.

Increasing knowledge of normal meniscal healing and meniscal vascularity has lead to the application of vascular enhancement techniques, and the ability to extend meniscal repair into the white-white zone.

Further understanding of basic science and the understanding of meniscal healing have allowed us to expand the potential for meniscal repair. In the treatment of difficult fractures and non-unions, growth factors, such as the bone morphogenic proteins, have had a dramatic impact in increasing healing rates.

Similarly, the future of meniscal repair will likely utilize growth factors as well as innovative vascular enhancement techniques to improve healing. Considering that no perfect substitute has been created to eliminate the problems seen after meniscal removal, we must continue to strive for meniscal preservation through meniscal repair.

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