The Benefits of Meniscal Repair and the Role of Fibrin Clot Augmentation

The Benefits of Meniscal Repair and the Role of Fibrin Clot Augmentation

When it comes to managing a torn meniscus, preserving the natural tissue through meniscal repair is increasingly becoming the gold standard—especially in young, active individuals. While not every tear is suitable for repair, advances in surgical techniques and biological adjuncts are expanding the indications and improving healing rates.

Why Meniscal Repair Matters

The meniscus plays a crucial role in knee function—it acts as a shock absorber, provides joint stability, and protects cartilage. Removing part of the meniscus (meniscectomy), while sometimes necessary, has been shown to accelerate degenerative changes and increase the risk of osteoarthritis. In contrast, meniscal repair preserves native tissue, which is associated with better long-term outcomes, particularly in younger populations.

Studies have shown that meniscal preservation leads to improved knee biomechanics, reduced cartilage wear, and improved return to sport. A systematic review by Fillingham et al. (2017) reported success rates of 75-90% for meniscal repairs, particularly when combined with biological augmentation.

The Role of Biological Adjuncts: Fibrin (Blood) Clot Augmentation

One of the most promising developments in meniscal repair is the use of biological augmentation, particularly fibrin clot augmentation, to promote healing in tears located in the avascular "white-white" zone of the meniscus.

Fibrin clots are rich in platelets, growth factors, and inflammatory cells, creating a scaffold that promotes cellular migration and tissue regeneration. When placed at the repair site, the fibrin clot enhances the local biological environment, stimulating vascular ingrowth and fibrovascular scar formation that helps bridge and heal the tear.

Take-Home Message

Meniscal repair, when possible, is the preferred treatment for suitable tears due to its joint-preserving benefits. The addition of fibrin clot augmentation can further improve outcomes, particularly in challenging, avascular tear zones. As our understanding of the biology of meniscal healing improves, biologically augmented repairs are likely to become standard practice in modern orthopaedic surgery.

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