Fibrin-Based Scaffold Augmentation During Meniscal Repair May Enhance Healing and Functional Outcomes: A Systematic Review.

BACKGROUND

Biologic augmentation techniques, such as fibrin-based scaffolds, have been proposed to enhance healing of meniscal tears, particularly in avascular zones. However, clinical outcomes remain variably reported.

STUDY

DESIGN

Systematic review; Level of evidence, 4.

PURPOSE: To evaluate the healing rate, complication rate, and patient-reported outcome scores after meniscal repair augmented with fibrin-based scaffolds.

METHODS

A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed, Embase, and Ovid MEDLINE through October 15, 2025. Studies evaluating fibrin-based augmentation during meniscal repair were included. Primary outcomes were healing and complication rates. Secondary outcomes included International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores.

RESULTS

Of 757 studies, 15 met inclusion criteria, comprising 438 patients with meniscal tears in mostly avascular zones. Of these, 345 underwent fibrin-based augmentation; the rest did not. There were 4 fibrin-based methods identified: fibrin clot from peripheral venous blood (FC-PVB; n = 252), fibrin clot from bone marrow aspirate concentrate (FC-BMAC; n = 30), platelet-rich fibrin (PRF; n = 15), and PRF combined with platelet-rich plasma (PRF+PRP; n = 48). Among patients who received FC-PVB, 77.5% achieved complete healing, 12.2% partial healing, and 10.3% failure. Complications occurred in 8.2% of patients who received FC-PVB and included paresthesia and reinjuries; 2.6% reported persistent knee pain. In FC-PVB studies, significant improvements were seen in IKDC and Lysholm scores but not in Tegner scores. Other fibrin-based methods showed consistent improvements across all scores. Compared to nonaugmented repair, fibrin-based augmentation yielded superior outcomes.

CONCLUSION

Fibrin-based augmentation demonstrated high healing rates, low complication rates, and improved clinical outcome scores. Compared to nonaugmented repair, fibrin-based scaffolds achieved better healing and function. FC-PVB enhanced symptom relief and functional recovery, while only FC-BMAC showed improvements in activity levels.