A three-dimensional printed silk-based biomimetic tri-layered meniscus for potential patient-specific implantation.

Employing tissue engineering principles aided by three-dimensional (3D) printing strategies to fabricate meniscus tissue constructs could help patients with meniscus injury regain mobility, improve pain management and reduce the risk of development of knee osteoarthritis. Here we report a 3D printed meniscus scaffold that biomimics the internal and bulk architecture of the menisci. A shear-thinning novel silk fibroin-gelatin-based bioink with high print fidelity was optimized for the fabrication of scaffolds to serve as potential meniscus implants. Physicochemical characterization of the fabricated scaffolds shows optimum swelling, degradation and mechanical properties. Further, the scaffolds were seeded with meniscus fibrochondrocytes to validate their bioactivity. Fibrochondrocytes seeded on the scaffolds maintained their phenotype and proliferation, and enhanced glycosaminoglycan and total collagen synthesis was observed. Gene expression profile, biochemical quantification and histological studies confirmed the ability of the scaffolds to form meniscus-like tissue constructs. The scaffolds were found to possess amenable immunocompatibility in vitro as well as in vivo. Due to their excellent biological and physicochemical characteristics, these 3D printed scaffolds may be fine-tuned into viable alternatives to the present clinical treatment approaches to meniscus repair.