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Fibrin-Based Scaffold Augmentation During Meniscal Repair May Enhance Healing and Functional Outcomes: A Systematic
Khaled Skaik1, Harjind Kahlon2, Marc Daniel Bouchard3
1Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Background:
Biologic augmentation techniques, such as fibrin-based scaffolds, have been proposed to enhance healing of meniscal tears, particularly in avascular zones. However, clinical outcomes remain variably reported.
Study Design:
Systematic review; Level of evidence, 4.
Purpose:
To evaluate the healing rate, complication rate, and patient-reported outcome scores after meniscal repair augmented with fibrin-based scaffolds.
Methods:
A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed, Embase, and Ovid MEDLINE through October 15, 2025. Studies evaluating fibrin-based augmentation during meniscal repair were included. Primary outcomes were healing and complication rates. Secondary outcomes included International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores.
Results:
Of 757 studies, 15 met inclusion criteria, comprising 438 patients with meniscal tears in mostly avascular zones. Of these, 345 underwent fibrin-based augmentation; the rest did not. There were 4 fibrin-based methods identified: fibrin clot from peripheral venous blood (FC-PVB; n = 252), fibrin clot from bone marrow aspirate concentrate (FC-BMAC; n = 30), platelet-rich fibrin (PRF; n = 15), and PRF combined with platelet-rich plasma (PRF+PRP; n = 48). Among patients who received FC-PVB, 77.5% achieved complete healing, 12.2% partial healing, and 10.3% failure. Complications occurred in 8.2% of patients who received FC-PVB and included paresthesia and reinjuries; 2.6% reported persistent knee pain. In FC-PVB studies, significant improvements were seen in IKDC and Lysholm scores but not in Tegner scores. Other fibrin-based methods showed consistent improvements across all scores. Compared to nonaugmented repair, fibrin-based augmentation yielded superior outcomes.
Conclusion:
Fibrin-based augmentation demonstrated high healing rates, low complication rates, and improved clinical outcome scores. Compared to nonaugmented repair, fibrin-based scaffolds achieved better healing and function. FC-PVB enhanced symptom relief and functional recovery, while only FC-BMAC showed improvements in activity levels.
