## 1 Introduction  
The menisci of the knee are wedge-shaped fibrocartilaginous structures located between the femoral condyles and the tibial plateau [1]. Meniscal tissue primarily consistsof water and type I collagen, intermingled with cells. Collagen constitutes 75% of the dry mass and forms the foundational structure of the menisci [1; 2; 3; 4; 5] Fibochondrocytes, the local cells within the meniscus, exhibit a variety of shapes. In the superficial layer, cells are fusiform or spindle-shaped, resembling fibroblasts, while the deeper layer comprises ovoid cells similar to chondrocytes [5; 6]. Furthermore, these zones are distinguished by their vascularity, which determines the meniscus's healing capacity. The peripheral zone, known as the \"red-red\" zone, is the most vascularized, with excellent healing potential. The \"white-white\" zone, with limited healing potential, is avascular, and a \"red-white\" transition zone exists between them, displaying characteristics of both zones [2; 6; 7; 8]. The menisci were previously regarded as embryonic remnants, despite their crucial role in maintaining the optimal biomechanical properties of the knee [9; 10]. They are responsible for joint stability, viscoelastic properties, shock absorption, load transmission, and strain distribution [11]. In the past, studies suggested that meniscal tears could only be repaired in the red zone, but it is now widely recognized that healing can also occur in the white zone. Due to an increasing understanding of their unique role, there is great emphasis on meniscus repair rather than removal, owing to their critical role in joint congruence, kinematics, and joint longevity [12]. Synoval inflammation intensifies the process of joint destruction, which correlates with degeneration of joint tissues and increased pain [13]. [PERSON] et al. observed that patients undergoing arthroscopic meniscectomy showed macroscopic low-grade synovitis in the suprapatellar pouch, and that this is an independent predictor of pre-operative worsening symptoms and pain [14]. [PERSON] et al. emphasized that targeting synovial inflammation in patients undergoing meniscectomy might be an optimal strategy in order to prevent cartilage degradation and reduce pain and dysfunction [14]. Knee osteoarthritis is a common degenerative and chronic joint disease which can be described as malformation of joint tissues, causing pain, swelling, and stiffness. All of these factors create disability in daily living due to the chronic knee pain [15; 16]. In the early stage of OA, cartilage damage also affects the meniscus and ligament integrity. The degenerated meniscus is often found in OA knees. On the other hand, in advanced OA, the presence of ruptured menisci is a strong factor contributing to the level of cartilage loss in knee OA [17]. Microscopically, menisci from osteoarthritis joints exhibit disruptions in architecture and the presence of cyst-like cavities in areas where matrix and cells should be, with these cavities lined by collagen fibers and elongated cells. The distribution of cells in pathologically changed menisci varies, including hypercellular, hypocellular, and acellular regions. Cells in meniscus pathology are often larger in size and can form clusters [18]. Degenerative lesions in the meniscus frequently coincide with articular cartilage damage, suggesting an early stage of osteoarthritis [17]. [PERSON] et al. noted that it remains controversial whether meniscus pathology or osteoarthritis precedes the other [19]. Furthermore, healthy menisci are seldom found in knees with osteoarthritis; instead, meniscal tears are frequently observed in knees with pathological changes [17]. The Bonar score is the most commonly used semiquantitative scoring system for assessing microscopic alterations in tendons. It consists of four main variables: tenocyte morphology, accumulation of ground substance, neovascularization, and the architecture of collagen bundles [20; 21].