Repair Augmentation of Unstable, Complete Vertical Meniscal Tears With Bone Marrow Venting Procedure: A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study

Kaminski, Rafal; Kulinski, Krzysztof; Kozar-Kamińska, Katarzyna; Waśko, Marcin; Langner, Maciej; Pomianowski, Stanisław

doi:10.1016/j.arthro.2018.11.056

Cited by 40 publications

(51 citation statements)

References 38 publications

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“…14,30,33 This may explain the improved outcomes of PRP augmentation in some of the studies included in this review. Previous studies 16,37 have compared the efficacy of isolated MR versus other biologic augmentation techniques, such as MR augmented with a bone marrow venting (BMV) procedure (ie, microfracture of the lateral intercondylar notch), and have demonstrated significantly improved meniscal healing rates and improved PROs in the BMV group at short-term and midterm follow-up, respectively.…”

Section: Discussionmentioning

confidence: 99%

Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies

Belk

Kraeutler

Thon

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: The effect of platelet-rich plasma (PRP) augmentation for meniscal repair (MR) is unclear, as current evidence is limited to small, mostly nonrandomized studies. Purpose: To systematically review the literature to evaluate the efficacy and safety of MR with PRP augmentation. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies (level of evidence 1-3) that compared the clinical efficacy of MR performed with versus without PRP. The search phrase used was platelet-rich plasma meniscus. Patients were assessed based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS) for pain, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the subjective International Knee Documentation Committee (IKDC) score, and treatment failure. Results: We identified 6 studies (2 studies with level 1 evidence; 4 studies with level 3 evidence) that met inclusion criteria, for a total of 309 patients undergoing MR with PRP (mean age, 31.9 years) and 445 patients without PRP augmentation (mean age, 29.6 years). The mean follow-up was 32.8 months (range, 12-72 months). Overall, 17.0% of PRP patients experienced MR failure compared with 22.1% of non-PRP patients. No differences in VAS, Lysholm, or subjective IKDC scores were found between groups except in 1 study, in which postoperative subjective IKDC scores were significantly better in the PRP group ( P < .01). Another study found significantly better postoperative WOMAC scores among PRP patients, and 2 studies found significantly better KOOS subscores among PRP patients. Conclusion: There are a limited number of high-quality studies comparing outcomes and healing rates between patients undergoing MR with versus without PRP augmentation. Based on the available evidence, patients undergoing MR with PRP augmentation experience similar clinical outcomes at midterm follow-up when compared with conventional MR, and additional studies are needed to determine the efficacy of MR augmented with PRP.

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Section: Discussionmentioning

confidence: 99%

Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies

Belk

Kraeutler

Thon

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…In both the groups, patients showed an improvement in pain score (VAS and KOOS) with no significant difference between groups. Functional outcomes (IKDC, WOMAC, KOOS) were significantly better in the BMVP group [141].…”

Section: Bone Marrow Venting Procedures (Bmvp) and Mesenchymal Stem Cmentioning

confidence: 87%

Biological Therapies in Orthopedics and Sports Medicine

Samitier

Alentorn-Geli

Filardo

et al. 2020

ESSKA Instructional Course Lecture Book

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“…5,14,51 Marrow stimulation techniques within the notch have thus been used as an adjunct to healing in isolated meniscal repair. 25 However, there are currently no data comparing marrow stimulation against PRP. Based on prior studies, PRP augmentation should presently be considered only in patients undergoing isolated meniscal repairs.…”

Section: Discussionmentioning

confidence: 99%

“…5,10,30,32 As such, there have been several biologic augmentation techniques described for meniscal repairs, including fibrin clot, marrow stimulation, and platelet-rich plasma (PRP), with varying degrees of success. 25,40,44 PRP to augment soft tissue reconstruction procedures has been suggested as a way to increase growth factors that enhance healing in the absence of large hemarthrosis. 13,21,22,50 However, the studies involving PRP augmentation for arthroscopic meniscal repair are limited by small sample sizes and a lack of consensus.…”

mentioning

confidence: 99%

Platelet-Rich Plasma Augmentation for Isolated Arthroscopic Meniscal Repairs Leads to Significantly Lower Failure Rates: A Systematic Review of Comparative Studies

Sochacki

Safran

Abrams

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Studies have reported relatively high failure rates of isolated meniscal repairs. Platelet-rich plasma (PRP) has been suggested as a way to increase growth factors that enhance healing. Purpose: To compare (1) meniscal repair failures and (2) patient-reported outcomes after isolated arthroscopic meniscal repair augmented with and without PRP. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. Multiple databases were searched for studies that compared outcomes of isolated arthroscopic meniscal repair augmented with PRP versus without PRP in human patients. Failures and patient-reported outcome scores were reported for each study and compared between groups. Study heterogeneity was assessed using I 2 for each outcome measure before meta-analysis. Study methodological quality was analyzed. Continuous variable data were reported as mean and standard deviation from the mean. Categorical variable data were reported as frequency with percentage. All P values were reported with significance set at P < .05. Results: Five articles were analyzed (274 patients [110 with PRP and 164 without PRP]; 65.8% male; mean age, 29.1 ± 4.6 years; mean follow-up, 29.2 ± 22.1 months). The risk of meniscal repair failure ranged from 4.4% to 26.7% for PRP-augmented repairs and 13.3% to 50.0% for repairs without PRP. Meniscal repairs augmented with PRP had significantly lower failure rates than repairs without PRP (odds ratio, 0.32; 95% CI, 0.12-0.90; P = .03). One of the 5 studies reported significantly higher outcomes in the PRP-augmented group versus the no-PRP group for the International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee injury and Osteoarthritis Outcome Score (KOOS) ( P < .05 for all). The remaining 4 studies reported no significant difference between groups with regard to outcomes for the IKDC, Lysholm knee scale, visual analog scale for pain, or Tegner activity level. Conclusion: Although the studies were of mostly of low quality, isolated arthroscopic meniscal repairs augmented with PRP led to significantly lower failure rates (10.8% vs 27.0%; odds ratio, 0.32; P = .03) as compared with repairs without PRP. However, most studies reported no significant differences in patient-reported outcomes.

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Repair Augmentation of Unstable, Complete Vertical Meniscal Tears With Bone Marrow Venting Procedure: A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study

Cited by 40 publications

References 38 publications

Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies

Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies

Biological Therapies in Orthopedics and Sports Medicine

Platelet-Rich Plasma Augmentation for Isolated Arthroscopic Meniscal Repairs Leads to Significantly Lower Failure Rates: A Systematic Review of Comparative Studies

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