Purpose
To characterize bone marrow aspirate–derived fibrin clot (BMA clot) and evaluate the
clinical result of meniscal repair with a BMA clot for isolated meniscal injury in
the avascular zone.
Methods
Blood counts of total leukocytes, platelets, and concentrations of basic fibroblast
growth factor (bFGF), transforming growth factor β (TGF-β), and stromal cell–derived
factor 1 (SDF-1) were analyzed with BMA, peripheral blood (PB), BMA clot, and PB clot
from 5 patients treated for meniscal repair. In addition, a retrospective analysis
of 30 patients with isolated avascular meniscal injuries who underwent repair with
a BMA clot was performed to assess rate failure. Avascular meniscal injury was identified
as horizontal tear, radial tear, and flap tear. Clinical failure was defined as the
presence of 1 or more of Barrett’s criteria. Anatomic failure was defined as the existence
of equivalent signal intensity to intra-articular fluid along the repair area on follow-up
magnetic resonance imaging (MRI). Patients’ demographic and clinical data were compared
between the overall failure group and the success group.
Results
The bFGF, TGF-β, and SDF-1 levels of BMA clots were more highly concentrated compared
with PB clots. The Lysholm scores and meniscal status evaluated by MRI were significantly
improved from preoperatively to postoperatively (both P < .001). The Kellgren-Lawrence grading of knee radiographs did not significantly
differ pre- and postoperatively (P = .140). Rates of clinical failure, anatomic failure, and retear were 10%, 6.7%,
and 3.3%, respectively. The demographic characteristics and surgical and postoperative
status did not significantly differ between the overall failure group and the success
group.
Conclusions
BMA clots had increased levels of cytokines compared to PB clots. The retrospective
analysis revealed that the rates of clinical failure and anatomic failure after meniscal
repair with a BMA clot for isolated avascular meniscal injury were 10% and 6.7%, respectively.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Published online: May 27, 2021
Accepted:
May 12,
2021
Received:
December 30,
2020
See commentary on page 450Footnotes
This research was funded by the Japan Society for the Promotion of Science (KAKENHI, grant No. 16K10871).
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
