Meniscus Injury Treatment with Platelet Rich Plasma (PRP) Injection.
Clinical and Functional Outcome of Meniscal Injuries Treated with Platelet-Rich Plasma (PRP).
Meniscal injuries are among the most frequently encountered and treated conditions in the knee joint and are responsible for clinical and functional impairment. Meniscus injuries and defects are also very common in young athletes, particularly in contact sports, having a huge impact on return to sport.
When the integrity of the meniscus is impaired, impact stresses within the knee joint are increased, this then having a strong association with progressive cartilage deterioration, which can lead to osteoarthritis. Therefore, treatment methods are required to prevent these potential complications. Various therapeutic strategies are currently available, but largely dependent on the extent and injury location. The meniscus has a unique blood supply, only their outer third has a vascular supply. Meaning that the inner surface is have a poor blood supply, meaning when there is damage, the repair rate is extremely poor. To combat this, platelet rich plasma (PRP) is frequently used to facilitate a repair and healing process. PRP treatment has been used in practice for almost a decade and providing good clinical outcomes for cartilage and meniscus injuries. Further information on PRP injection treatment can be found here.
The recent 2020 to study looked at the clinical and functional outcomes are PRP treatment on meniscal injuries. The findings of the study confirmed the clinical/functional benefit of PRP joint and percutaneous injections for meniscal lesions, as previously described by Blanke et al. for intrasubstance meniscus injury. The most important finding in the study was that the patient scores post treatment after PRP therapy. They achieved significant improvements with a patients’ satisfaction rate of 100% (very satisfied/satisfied) at at average volume up to 3 months, with zero complications.
Research on conservative treatment modality for the treatment of meniscal injuries is extremely limited. Nonsurgical options include rest, immobilisation, reduced weightbearing, physical rehabilitation therapy, and intraarticular injections (steroid or hyaluronic acid). No drugs or therapies have proven to result in clinically relevant benefits in comparison with removal surgery. Much research has proven the musculoskeletal benefits and safety of PRP on many conditions related to sports injuries and orthopaedics. Most of the published evidence on PRP has focused on its influence to treat tendon, muscle, and cartilage issues. However, a reduced number have been made regarding the use of PRP for the treatment of meniscal injuries. The additive effect of PRP has been evaluated on open meniscal repair for grade 2–3 horizontal meniscal injuries through a case–control study. PRP improved clinical outcomes when injected into the lesion at the end of the procedure after a standard open meniscal repair, and when compared with this surgical procedure alone. A preclinical study looked to analyse the clinical benefits of PRP in meniscal tissue regeneration employing a gelatin hydrogel described remarkable healing properties.
This recent study reported here assessed the combination of both joint and percutaneous PRP injection treatment. This combined approach may have multiplied the potential influence of the meniscal tissue. It has previously been suggested that the early success of PRP injections may be related to the reduction in synovial joint inflammation and the facilitated healing of the meniscus. This approach may enhance meniscal healing through a more localised action of the PRP therapy. Patients were advised to perform mobility exercises following PRP treatment.
The study concluded that PRP injection treatment is a safe and effective treatment modality for stable meniscal injuries through percutaneous and joint PRP therapy. Clinical results achieved clinically relevant and statistically significant improvements in patient-reported pain and functional outcomes. These encouraging findings should reinforce additional controlled, clinical trials on larger patient populations in order to further identify whether PRP injections could be an alternative to surgical treatment for stable meniscal injuries.
Please see study here
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