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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
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.
Standard of care meniscal repair without augmentation.
Eagle Ridge Hospital
Port Moody, British Columbia, Canada
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.
Time frame: 6 months
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.
Time frame: Baseline, 3 months, 6 months 12 months
VAS Pain Score - Visual Analog Scale
Pain Visual Analog Scale.
Time frame: Baseline, Post-op Day 1, 6 weeks
Range of motion
Knee range of motion measurements.
Time frame: 6 weeks, 3 months, 6 months, 12 months
Tegner Score
Return to pre injury activity level as measured by the Tegner Score.
Time frame: Baseline, 3, 6 and 12 months post treatment
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