Restoring joint homeostasis: A dynamically adaptive meniscal scaffold prevents osteoarthritis by replicating native biomechanics

Abstract The failure of meniscal implants often stems from their inability to replicate the dynamic mechanical adaptability of the native tissue, leading to stress imbalances and irreversible joint degeneration. Current scaffolds, designed for static structural mimicry, fail to reproduce the crucial “compression‐to‐tension” conversion mechanism, resulting in high failure rates and accelerated osteoarthritis. Here, we report a paradigm shift from static mimicry to dynamic functional replication by engineering a biomimetic textile‐based meniscal scaffold (AN‐3DWKS). Our approach utilizes a textile micro‐forming strategy to construct a three‐dimensional anisotropic fiber‐interlocked skeleton, which is then integrated with a mechanically optimized annealed hydrogel. This composite scaffold exhibits a native‐like biphasic mechanical response: it is compliant under low strain for stress buffering but stiffens under high strain, converting axial loads into circumferential tension with a load‐bearing capacity exceeding 2400 N. Finite element analysis reveals this behavior is driven by the synergistic interplay between the hydrogel matrix and the sequential engagement of the fiber network. In a 24‐week rabbit model of total meniscectomy, the AN‐3DWKS restored joint mechanical homeostasis, maintained cartilage integrity at levels statistically comparable to those in the sham group, and suppressed inflammatory markers (TNF‐α). This work establishes a new design principle for load‐bearing soft tissues, demonstrating that emulating dynamic physiological responsiveness is the key to long‐term functional restoration and osteoarthritis prevention.