Summary:Clinical and experimental studies have demonstrated the importance of the meniscus in load transmission, stability, shock absorption, and articular cartilage nutrition in the knee joint. As a result, clinicians have emphasized preservation of the injured meniscus when possible. Meniscal healing is dependent on a blood supply or factors derived from serum. An exogenous fibrin clot placed in a stable lesion in an avascular portion of the meniscus can support a reparative response by providing such serum factors. In this review we describe the basic science aspects of meniscal repair, and the indications, technique, and results of meniscal repair using an exogenous fibrin clot. Directions for future research on meniscal repair and replacement based on our increasing understanding of meniscal biology are briefly discussed.