The Use of Fibrin Clot During Meniscus Repair in Young Patients Reduces Clinical Symptom Rates at 12-Month Follow-Up: A Pilot Randomized Controlled Trial.

Background and Objectives: The menisci are crucial fibrocartilaginous structures of the knee joint and have to be repaired in case of a tear. However, not all meniscal tears heal, even in young patients. Fibrin clot (FC) started to be used to reduce the failure rates following meniscus repair. The purpose of this study is to evaluate and compare outcomes after isolated arthroscopic meniscal repair augmented with FC versus without FC. Materials and Methods: Fifty-nine patients aged under 19 with isolated meniscal tears were randomized into two groups: one group underwent the meniscal repair with FC (FC-augmented), and the other group did not receive FC (control). The evaluation and comparison between the groups based on FC augmentation included secondary arthroscopy rates, patient-reported outcome measures (Pedi-IKDC, Lysholm, and Tegner), and clinical and radiological (MRI) assessments at a median follow-up of 12 months. Results: No statistically significant difference was observed between FC-augmented and control groups in Pedi-IKDC, Lysholm, and TAG scores, or following clinical and radiological (MRI) evaluation. Patients in the FC-augmented group reported fewer clinical symptoms at the final follow-up across unstable and demanding (bucket-handle and complex) tear type subgroups (p = 0.012 and 0.041, respectively). Overall, nine revision arthroscopies occurred in both groups (2 and 7, respectively), all across bucket-handle and complex tears with no significant difference between the FC-augmented and control groups (p = 0.072). Conclusions: This pilot study found that FC usage during meniscal repair reduces clinical symptoms for patients with unstable, bucket-handle, or complex meniscal tears at the final follow-up of 12 months postoperatively. Nonetheless, no statistically significant differences were observed within the other outcome measures between the FC-augmented and control groups and subgroups based on meniscal tear types. Level of evidence: Level II.