Short-Term Outcomes of Percutaneous Trephination with a Platelet Rich Plasma Intrameniscal Injection for the Repair of Degenerative Meniscal Lesions. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study
by
Rafal Kaminski 1,*
, Marta Maksymowicz-Wleklik 1, Krzysztof Kulinski 1, Katarzyna Kozar-Kaminska 2, Agnieszka Dabrowska-Thing 3 and Stanislaw Pomianowski 1
Rafal Kaminski 1,*, Marta Maksymowicz-Wleklik 1, Krzysztof Kulinski 1, Katarzyna Kozar-Kaminska 2, Agnieszka Dabrowska-Thing 3 and Stanislaw Pomianowski 1
1
Department of Musculoskeletal Trauma Surgery and Orthopaedics, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland
2
Department of Medical Biology, The Stefan Cardinal Wyszynski Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland
3
Departament of Radiology, Centre of Postgraduate Medical Education in Warsaw, ul. Konarskiego 13, 05-400 Otwock, Poland
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(4), 856; https://doi.org/10.3390/ijms20040856
Received: 28 January 2019 / Revised: 8 February 2019 / Accepted: 12 February 2019 / Published: 16 February 2019
(This article belongs to the Special Issue Blood-Derived Products for Tissue Repair/Regeneration)
Meniscal tears are the most common orthopaedic injuries, with chronic lesions comprising up to 56% of cases. In these situations, no benefit with surgical treatment is observed. Thus, the purpose of this study was to investigate the effectiveness and safety of percutaneous intrameniscal platelet rich plasma (PRP) application to complement repair of a chronic meniscal lesion. This single centre, prospective, randomized, double-blind, placebo-controlled study included 72 patients. All subjects underwent meniscal trephination with or without concomitant PRP injection. Meniscal non-union observed in magnetic resonance arthrography or arthroscopy were considered as failures. Patient related outcome measures (PROMs) were assessed. The failure rate was significantly higher in the control group than in the PRP augmented group (70% vs. 48%, P = 0.04). Kaplan-Meyer analysis for arthroscopy-free survival showed significant reduction in the number of performed arthroscopies in the PRP augmented group. A notably higher percentage of patients treated with PRP achieved minimal clinically significant difference in visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) symptom scores. Our trial indicates that percutaneous meniscal trephination augmented with PRP results in a significant improvement in the rate of chronic meniscal tear healing and this procedure decreases the necessity for arthroscopy in the future (8% vs. 28%, P = 0.032).
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Keywords:
meniscus; meniscus repair; meniscus tear; trephination; platelet-rich plasma; PRP; chronic meniscal lesion; horizontal meniscal tear
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Kaminski, R.; Maksymowicz-Wleklik, M.; Kulinski, K.; Kozar-Kaminska, K.; Dabrowska-Thing, A.; Pomianowski, S. Short-Term Outcomes of Percutaneous Trephination with a Platelet Rich Plasma Intrameniscal Injection for the Repair of Degenerative Meniscal Lesions. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study. Int. J. Mol. Sci. 2019, 20, 856.
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