Our colleagues UCA – Doctor Mikel Sánchez and Nicolas Fiz et al from Vitoria Spain, just published results on treating degenerative meniscus tears with PRP (Platelet Rich Plasma) injections.
https://link.springer.com/article/10.1007/s00167-023-07470-4
The data was recently presented TOBI: The Orthobiologic Institute Last month in Las Vegas.
The study analyzed 392 patients with a median age of 52. Following MRIs with symptomatic degenerative meniscus tears and failure of conservative treatment, patients received an intraarticular joint (lateral infrapatellar) w/ 3 weekly infiltrations. Additionally at weeks 1 & 3 patients received intra-meniscus injection under ultrasound guidance.
120 blood samples were randomly analyzed for quality control yielding an avg plt concentration of 1.9x baseline. The PRP used had no WBC, NO RBC and CaCl was used for activation.
The authors injected 8cc of PRP Into the joint along with 1-2cc of PRP into the meniscus wall and another 1-2cc into the meniscus capsular junction.
Only 10% of the candidates required surgery (36 meniscectomies and 2 meniscus repairs) demonstrating a 90% survival rate. This is especially important because removing the meniscus in a patient with underlying cartilage wear via meniscectomy surgery, can predispose to further degeneration altering the meniscus shock absorbing function. Additionally, studies have shown mixed results performing meniscectomies in degenerative tears and more conservative options are needed.
Importantly, horizontal tears had superior survival rates vs radial and complex tears. Perhaps because horizontal tears extend to peripheral regions rendering more favorable tissue repair.
Side effects were minimal although patients reported increased pain post treatment for 2-3 days likely from increased intra-meniscal pressure. 23g needles with a small 1cc syringe was used to minimize meniscus injection discomfort.
Hat’s off to our friends from Spain for publishing their work that advances our understanding of PRP use in knee meniscus injuries.
