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This study will compare meniscal healing with or without platelet rich plasma. The assessments will include validated, disease specific, patient oriented outcome measures, MRI arthrogram (MRA). Results of this study will help ascertain whether PRP improves meniscal healing rates.
Null Hypothesis: There is no difference in meniscal healing with or without the use of PRP.
The integrity of the meniscus is pivotal to the distribution of joint reaction forces and shock absorption across the knee and meniscal damage can lead to secondary degenerative joint disease. This has lead to treatments directed towards repairing and preserving the meniscus to alter the progression of joint degeneration. Although success rates of meniscal repair are greater when performed in association with anterior cruciate reconstruction, healing rates remain in the 70-80% range for isolated repairs.
Therefore, techniques such as the use of fibrin clots, trephining and rasping of the tissues, have been incorporated to improve healing results of meniscal repair. There has been a surge of enthusiasm for the use of Platelet Rich Plasma (PRP) to improve healing rates of soft tissue injuries. Therefore, it may be reasonable to surmise that applying blood products, such as thrombin and platelet rich plasma, to the meniscal repair bed may induce more complete and possibly faster healing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| With PRP | Experimental | Standardized meniscal repair with PRP (platelet rich plasma) in the meniscal healing bed. |
|
| Without PRP | Active Comparator | Standardized meniscal repair without PRP (platelet rich plasma). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| With PRP | Procedure | Following meniscal repair, PRFM will be delivered arthroscopically into the tear site using a portal skid, arthroscopic canula and arthroscopic atraumatic tissue grasper into the interface of the repair site. |
| Measure | Description | Time Frame |
|---|---|---|
| MRA (magnetic resonance imaging arthrography | The primary outcome measures will be assessment of meniscal healing integrity using magnetic resonance imaging arthrography six months post repair. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| WOMET - Western Ontario Meniscal Outcome Measure | The WOMET is a disease-specific validated tool designed to evaluate HRQOL (Health Related Quality of Life) in patients with meniscal pathology (meniscal tears or in patients who have undergone meniscal repair or resection). In this subset of patients with meniscal pathology, the WOMET has been found to be reliable, valid and responsive. The WOMET has 16 items including the domains of physical symptoms, sports/recreation/work/lifestyle, and emotions. It demonstrated adequate content and construct validity when compared with other measures. Test-retest reliability was assessed and was found to be high, with an intraclass correlation coefficient of 0.833. |
| Measure | Description | Time Frame |
|---|---|---|
| Second look arthroscopy | If a second look arthroscopy is performed, the status of the meniscus (healed or not healed) will be compared to the MRA findings. Second look arthroscopy will be performed on subjects with clinical indication of a failed meniscal repair. Clinical indications of failed meniscus repair include persistent pain and symptoms or MRA positive for a meniscus repair. | if applicable |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Robert G. McCormack, MD, FRCSC | Simon Fraser Orthopaedic Fund / Fraser Health Authority / University of British Columbia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Eagle Ridge Hospital | Port Moody | British Columbia | V3H 3W9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
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|
| Without PRP | Procedure | Standard of care meniscal repair without augmentation. |
|
| Baseline, 3 months, 6 months 12 months |
| VAS Pain Score - Visual Analog Scale | Pain Visual Analog Scale. | Baseline, Post-op Day 1, 6 weeks |
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