Ultrasound-guided meniscal injection of autologous conditioned plasma: a case series at middle-term evaluation

Abstract

Introduction

Symptomatic degenerative meniscal tears are a tough challenge in daily clinical practice for orthopedic surgeons. Arthroscopic partial meniscectomy led to high cost, little improvement to Quality of Life and faster progression of OA. Thus, urgency for new conservative therapeutic strategies is emerging.

Objectives

To provide a report of the results of ultrasound (US)-guided intrameniscal injections with a solution of autologous conditioned plasma (ACP) in a group of active patients suffering of symptomatic degenerative meniscal tears.

Methods

Forty-seven patients were treated by 3 US-guided intra- and perimeniscal injections of ACP (Arthrex) at 2 weeks interval, and prospectively assessed at baseline and at 12, 24 and then at final 36 months’ follow-up, using Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee-subjective score, Visual Analog Scale, Tegner Activity Scale.

Results

Around two-thirds of the patients (32, 68.09%) declared to be satisfied by the procedure.

No correlation was found between age, sex, and body mass index and score variation, according to the multivariate analysis.

Thirty patients (63.8%) registered an increase of at least 10 points in Knee Injury and Osteoarthritis Outcome Score at 1 year of follow-up, thus were identified as responder. Seventeen failures were reported (failure rate: 36%).

Conclusions

This study highlighted the potential benefit of an US-guided intrameniscal injective procedure using ACP for the management of symptomatic degenerative meniscal lesions. Further randomized controlled studies are needed to confirm the efficacy of ACP as a therapeutic option for degenerative meniscal tears.