Biological Augmentation of Meniscal Repair: A Review with Insights into Injectable Hydrogel Delivery

Meniscal injuries are common and often lead to chronic pain, joint instability, and an increased risk of osteoarthritis. Traditional treatments, such as partial meniscectomy, may accelerate joint degeneration. In recent years, biologically active therapies, including platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), hyaluronic acid (HA), bone marrow aspirate concentrate (BMAC), collagen, growth factors (GFs), and silk fibroin (SF), have emerged as promising strategies to enhance meniscal healing. This review evaluates the efficiency of these biological agents in promoting meniscal repair, with a particular focus on their potential integration into injectable hydrogel systems for targeted, minimally invasive delivery. Recent literature from 2015 to 2025 has provided growing insights into the role of biologically active agents and biomaterials in meniscal repair. Among the agents studied, PRP, MSCs, and HA have shown particular promise in modulating inflammation and supporting tissue regeneration. While biological therapies alone may not replace surgery for complex tears, they offer promising, less invasive alternatives that support tissue preservation. However, variability in study design, agent quality, and treatment protocols remains challenging. Further long-term research will be essential to confirm clinical benefits and optimize hydrogel-based delivery methods.