Journal of orthopaedics · 2025
Platelet rich plasma augmentation for meniscus repair reduces failure but not complication rates or outcomes: A systematic review and meta-analysis.
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Dave Udit, Rubin Jared, Chang Nicole, Alli Nurudeen, Atkins Myles, Moran Thomas E, Bi Andrew S, Haynes Monique, Verma Nikhil N, Chahla Jorge
Аннотация
INTRODUCTION: Platelet rich plasma (PRP) has been shown to promote healing, especially in areas with poor vascularity, such as the inner third of the meniscus. The purpose of this systematic review and meta-analysis was to compare post-operative outcomes and complications among patients who have undergone meniscus repair with and without PRP augmentation.
METHODS: In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library databases were searched in December 2024 for studies published after 2004. Studies met inclusion criteria if they included patients who underwent meniscal repair without concomitant procedures and were comparative studies evaluating outcomes in patients who underwent meniscal repair with and without PRP treatment. Studies not written in English or not directly comparing patients undergoing meniscus repair with and without PRP were excluded. Two-proportion z-tests were performed to assess for a statistically significant difference in the proportion of each complication within the PRP cohort versus the control cohort. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool for RCTs and MINORS criteria for non-RCTs.
RESULTS: The initial search identified 862 studies, of which 8 were included, each with sufficiently low risk of bias. A total of 354 patients were included with 180 patients in the PRP cohort and 174 patients in the control cohort. Mean age across cohorts ranged from 26.0 to 70.0 years. Mean follow-up times ranged from 3.0 to 48.0 months. Similar mean values were reported in patient-reported outcomes including Lysholm, VAS, IKDC, and WOMAC scores across both cohorts. Patients undergoing meniscus repair with PRP augmentation had significantly fewer re-tears/failures (18.2 %) than patients undergoing repair without PRP augmentation (30.5 %), (p = 0.0188); however, there was no significant difference in rate of re-operations, wound complications, or infection between the two cohorts.
CONCLUSIONS: While significant heterogeneity in study methodology exists within the comparative literature, limited evidence exists suggesting a significantly decreased rate of re-tear or failure in patients undergoing meniscus repair with PRP augmentation versus without PRP augmentation.
LEVEL OF EVIDENCE: Level III, Systematic Review and Meta-Analysis of Level I-III studies.
METHODS: In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library databases were searched in December 2024 for studies published after 2004. Studies met inclusion criteria if they included patients who underwent meniscal repair without concomitant procedures and were comparative studies evaluating outcomes in patients who underwent meniscal repair with and without PRP treatment. Studies not written in English or not directly comparing patients undergoing meniscus repair with and without PRP were excluded. Two-proportion z-tests were performed to assess for a statistically significant difference in the proportion of each complication within the PRP cohort versus the control cohort. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool for RCTs and MINORS criteria for non-RCTs.
RESULTS: The initial search identified 862 studies, of which 8 were included, each with sufficiently low risk of bias. A total of 354 patients were included with 180 patients in the PRP cohort and 174 patients in the control cohort. Mean age across cohorts ranged from 26.0 to 70.0 years. Mean follow-up times ranged from 3.0 to 48.0 months. Similar mean values were reported in patient-reported outcomes including Lysholm, VAS, IKDC, and WOMAC scores across both cohorts. Patients undergoing meniscus repair with PRP augmentation had significantly fewer re-tears/failures (18.2 %) than patients undergoing repair without PRP augmentation (30.5 %), (p = 0.0188); however, there was no significant difference in rate of re-operations, wound complications, or infection between the two cohorts.
CONCLUSIONS: While significant heterogeneity in study methodology exists within the comparative literature, limited evidence exists suggesting a significantly decreased rate of re-tear or failure in patients undergoing meniscus repair with PRP augmentation versus without PRP augmentation.
LEVEL OF EVIDENCE: Level III, Systematic Review and Meta-Analysis of Level I-III studies.