Summary: For difficult meniscus repairs, pulling a blood clot into the tear with a suture ensures that it stays in place during the repair. This is a reliable and successful technique for tears which may otherwise not heal due to chronicity, vascularity or complexity.

Introduction

Repairing a torn meniscus is preferable to removing it. However, some tears may have a poor chance of healing due to chronicity, vascularity or complexity. In many of these cases augmentation of the repair with fibrin blood clot may enhance the healing capacity. Pulling the clot into the tear with a suture ensures that it stays in position while repair is undertaken. This technique has been studied in a consecutive series of patients. The aim of this paper is to evaluate the outcome of this technique and to assess survivorship of the repairs.

Methods

A consecutive series of 52 patients over a 4-year period undergoing suture repair of a meniscus tear with blood clot augmentation were collected from a prospectively collected database. These have been followed and have completed outcome scores and a questionnaire. Survivorship end point was defined as pain secondary to meniscal pathology, further arthroscopy for re-repair or resection and further knee surgery such as osteotomy or replacement. Clinical examination or MRI scanning was not undertaken as part of the review.

Results

The cohort comprised 32 males and 20 females with a mean age of 35 (14-70). There were 28 left and 24 right knees and the medial meniscus was repaired in 32 knees and the lateral in 20. Complete radial tears were the most common type repaired followed by longitudinal and transverse cleavage tears. Only 2% of tears were considered to be in the red-red zone while 82% were in the white-white zone. Follow-up ranged from 12 months to 7 years. Only 1 patient is known to have come to subsequent arthroscopic surgery to the repaired meniscus at another hospital. Lysholm scores improved from 53.97 (SD 18.14) to 92.08 (SD 8.97), Oxford Knee Scores improved from 29.84 (SD 9.65) to 45.79 (SD 2.66), KOOS pain scores improved from 61.49 (SD 22.76) to 93.54 (SD 8.06) and Tegner scores improved from 4.56 (SD 3.35) to 6.05 (SD 2.41).

Conclusions

Pulling a fibrin blood clot into a meniscus tear with a suture ensures that the clot remains in place while the meniscus is repaired. Patients have shown excellent outcomes at a mean follow up of 45 months with 98% survivorship at that time. This is a reliable technique for augmenting meniscus repairs especially for tears which would commonly otherwise not have been repaired.

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Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis ePoster Presentation Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR Chris Saunders, PhD MBChB BMedSci (Hons), UNITED KINGDOM Matthew Sedgwick, Ph.D., UNITED KINGDOM
Lateral Meniscal Posterior Root Repair with Concurrent ACL Reconstruction: Patient-Report Outcomes and Risk Factors for Failure ePoster Presentation Evan W. James, MD, UNITED STATES Per-Henrik Randsborg, MD, PhD, NORWAY Joseph T. Nguyen, MPH, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Answorth A. Allen, MD, UNITED STATES Scott A. Rodeo, MD, UNITED STATES Robert G. Marx, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
The Fate of Discoid Lateral Meniscus With and Without Osteochondritis Dissecans of the Lateral Femoral Condyle After Surgery ePoster Presentation Ken Iida, MD, JAPAN Yusuke Hashimoto, MD, PhD, JAPAN Yohei Nishida, MD, JAPAN Junsei Takigami, MD, PhD, JAPAN Tomohiro Tomihara, MD, JAPAN Hiroaki Nakamura, MD, PhD, JAPAN
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Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
Higher Signal Intensity of Repaired Lateral Meniscus on MRI Indicates the Risk Of Residual Rotatory Knee Laxity After ACL Reconstruction ePoster Presentation Daisuke Chiba, MD, PhD, JAPAN Yuji Yamamoto, MD, JAPAN Yuka Kimura, MD, PhD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Accuracy of Magnetic Resonance Imaging for Detecting Meniscal Tears in Anterior Cruciate Ligament injuries. ePoster Presentation Artit Boonrod, MD, THAILAND Watcharapong Wongsawiang , MD, THAILAND Punthip Thammaroj , MD, THAILAND Sermsak Sumanont, THAILAND Punyawat Apiwatanakul, MD, THAILAND Arunnit Boonrod, MD, THAILAND
"Repair Or Resect? That Is The Question!" Inside-Out Repair Of Long Meniscus Tears Is Used to Identify Prognostic Factors and Improve Decision-Making ePoster Presentation Iftach Hetsroni, MD, Associate Prof., ISRAEL Yakir Carmeli, B.Ed., ISRAEL Shiri Bretter, M.ed, ISRAEL Gabriel Marino, MD, ISRAEL Ayelet Gonen-Vonkler, BA, ISRAEL Altaieb Agbaria, MD, ISRAEL Gideon Mann, MD, Prof., ISRAEL Nissim Ohana, MD, ISRAEL Moshe Ayalon, PhD, ISRAEL
Strength-Based Rehabilitation On Clinical Outcomes In Patients Post-Meniscectomy: A Systematic Review and Meta-Analysis ePoster Presentation Prushoth Vivekanantha, MD, CANADA Yi (David) Diao, BMSc, CANADA Dan Cohen, MD, CANADA Ben Murphy, DPT, CANADA Darren L. de SA, MD MBA FRCSC, CANADA
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
Do All Meniscal Ramp Lesions Require Repair? A Prospective Study Of Ramp Lesions with Concomitant ACL Injury? ePoster Presentation Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Meet Mehta, MD orthopaedics, INDIA Terence Dsouza, MS, DNB, FNB, INDIA Ramakanth Rajagopalakrishnan, D.ortho, DNB(ortho).D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Large Posterolateral Cartilage Slope Is a Risk Factor for Noncontact ACL Injury ePoster Presentation Kensuke Hotta, MD, JAPAN Mitsuru Hanada, MD, PhD, JAPAN Kazuki Nomoto, MD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, Prof., MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY
Predictors of The Ten-Year Patient-Reported Outcome Measures After Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency ePoster Presentation Alberto Grassi, PhD, ITALY Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Giacomo Dal Fabbro, ITALY Nicola Pizza, MD, ITALY Marianna Viotto, ITALY Luca Ambrosini, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images ePoster Presentation Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD,MPH, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN

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Meniscus Repair Augmentation Using Blood Clot

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