Self-Lubricating and Self-Healing Polyurethane Elastomer as a Meniscal Prosthesis to Delay Osteoarthritis Progression

The absence of a meniscal prosthesis that fully accommodates the complex motion demands of the human knee joint remains a challenge in clinical practice. This study synthesized a polyurethane elastomer with enhanced mechanical properties, featuring a dynamic dimethyldioxime-urethane structure that provides self-healing capabilities. Additionally, adamantane-grafted hyaluronic acid has been integrated into polyurethane containing cyclodextrin, imparting self-lubricating properties through supramolecular host-guest interactions between adamantane and cyclodextrin. This innovative polyurethane elastomer is utilized to fabricate a meniscal prosthesis (DPU@HA). In vitro experiments demonstrated DPU@HA's exceptional cytocompatibility with chondrocytes. In vivo studies revealed that DPU@HA significantly protected articular cartilage following meniscus removal by reducing the high mechanical stress within the cartilage, thereby inhibiting Piezo1 overactivation and subsequent chondrocyte apoptosis. With its self-healing and self-lubricating properties, the meniscal prosthesis (DPU@HA) holds promise for clinical applications in preventing the progression of osteoarthritis after meniscectomy.