Platelet-rich plasma for open meniscal repair in young patients: any benefit?

Platelet-rich plasma for open meniscal repair in young patients: any benefit?

Purpose. Many studies have demonstrated that injection of various growth factors including platelet-derived growth factor could increase meniscal cell activity and stimulate repair. The purpose of this study was to augment repair and promote meniscal healing by the use of platelet-rich plasma (PRP) within horizontal cleavage meniscal tears repaired via an open approach. The hypothesis was that the clinical outcomes and healing process would be improved using this meniscal healing augmentation technique.

Methods. In this case-control study, 34 consecutive young patients underwent an open meniscal repair to treat symptomatic Grade 2 or Grade 3 horizontal meniscal tears [median age 28 years (13-40)]. The median time between the onset of symptoms and surgery was 11.5 months (6-50). In the first group (17 consecutive patients, Group 1), a standard open meniscal repair was performed. In the second group (17 consecutive patients, Group 2), the same surgical repair was performed, but platelet-rich plasma was introduced into the lesion at the end of the procedure. Clinical outcomes were evaluated using KOOS and IKDC 2000 scores. MRI was performed at 1 year after surgery for objective evaluation.

Results. At a minimum of 24 months postoperatively (mean 32.2 months, 24-40), three patients underwent subsequent meniscectomy (two in Group 1, one in Group 2). The mean KOOS distribution (pain, symptoms, daily activities, sports, quality of life) was 78.4, 86.1, 93.8, 74.4, 74.6 in Group 1, and 93.3, 90.7, 97.1, 88.8, 78.3 in Group 2 (p < 0.05 for pain and sports parameters). MRI revealed five cases with the complete disappearance of any hypersignal within the repaired meniscus in Group 2, and none in Group 1 (p < 0.01).

Conclusions. Open meniscal repair of horizontal tears extending into the avascular zone was effective at midterm follow-up in young patients. Clinical outcomes were slightly improved by the addition of PRP in this case-control study.

Level of evidence. III.

http://www.ncbi.nlm.nih.gov/pubmed/25377191

Knee Surg Sports Traumatol Arthrosc

Enero 2015