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Biologic Augmentation during Meniscal Repair.

Christian L Blough¹, Christopher M Bobba², Alex C DiBartola³

¹Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California.

The Journal of Knee Surgery

|November 15, 2021

Summary

Biologic augmentation in meniscal repair, including platelet-rich plasma (PRP) and bone marrow stimulation, may reduce failure risk for isolated tears. However, evidence for other methods and improved knee function is limited.

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Area of Science:

Orthopedic Surgery
Regenerative Medicine
Sports Medicine

Background:

Meniscal tears are common knee injuries, and surgical repair aims to restore function.
Biologic augmentation techniques are increasingly explored to enhance meniscal repair outcomes.
The efficacy of various biologic agents in meniscal repair requires systematic evaluation.

Approach:

A systematic literature review was conducted using PubMed and Embase databases.
Included were human clinical studies on meniscal repair with biologic augmentation (PRP, fibrin clot, bone marrow stimulation, meniscal wrapping, bioscaffolds).
Outcome measures assessed repair failure, functional scores, and imaging results, with study quality evaluated using the modified Coleman methodology score.

Key Points:

Platelet-rich plasma (PRP) and bone marrow stimulation augmentation showed potential in decreasing failure rates for isolated meniscal repairs.
Fibrin clot and trephination augmentation lacked sufficient evidence to support reduced failure risk.
Meniscal wrapping and scaffold implantation may be beneficial for complex tears not suitable for primary repair, but require further study.

Conclusions:

Current evidence supporting biologic augmentation in meniscal repair is limited.
Augmentation shows the most promise for isolated meniscal repairs or those not typically amenable to repair alone.
Further research is needed to confirm the benefits of specific augmentation techniques and improve patient outcomes.