Meniscal repair using fibrin clot from autologous blood: description of the surgical technique

Abstract

The meniscus plays an important role in the function and biomechanics of the knee. It is an essential part of the knee joint, increasing contact area and joint congruence, lubricating articular surfaces and at the same time decreasing contact forces and absorbing shock. Meniscal tear is the most common injury to the knee that requires surgery. Traumatic meniscal tears are common in young patients with sports-related injuries. Most tears are treated by partial meniscectomy. However, patients who underwent meniscectomy noted long-term arthritic changes. An in vitro study showed that the removal of 16% to 34% of the meniscus resulted in a 350% increase in contact forces. So efforts have been made to preserve meniscus, and meniscal repair has become the preferred treatment of choice over meniscectomy, especially for young active patients and for peripheral longitudinal tears. Augmentation techniques, such as fibrin clot, synovial rasping, vascular access channels, platelet-rich plasma, fibrin glue, fascial – sheath coverage, rasping of the intercondylar notch may extend the indication for repair and improve success rates after meniscal repair especially in the central avascular zone of the meniscus. Meniscal repair using a fibrin clot was first introduced by King in 1938 and became popular by Arnoczky and Warren in 1983. There have been a few experimental in animals as well as in human studies that show good results of meniscal repairs using fibrin clot. In this paper we explain in details, the procedure we follow treating a case Abstract