Platelet Rich Plasma (PRP) For Meniscus Tear: A Comprehensive Guide

Updated: Feb 29

Meniscus tears are a common injury among athletes and weekend warriors, but they can also occur in people of all ages and activity levels. The meniscus is a piece of cartilage that acts as a cushion and stabilizer in the knee joint. A meniscal lesion can cause pain, swelling, and stiffness in the knee, making it difficult to perform everyday activities.

Platelet-rich plasma (PRP) therapy is a non-invasive, non-surgical treatment that uses platelets from the patient's own blood to promote healing for meniscus repair. Platelets contain growth factors that can help to repair damaged tissue. For meniscus tears, platelet-rich plasma injections can reduce pain and inflammation, improve function, and promote healing. [2]

Platelet-rich plasma therapy has shown to be effective in treating a variety of musculoskeletal conditions, including meniscal injury and supplementary treatment of anterior cruciate ligament reconstruction. [3] [4] In a study of patients undergoing meniscus tear repairs, augmenting with platelet-rich plasma injections was found to be significantly more effective than placebo injections in reducing pain and decreasing failure rates. [5]

If you are suffering from a meniscal lesion, especially a minor tear, platelet-rich plasma therapy alone may be a good option for you. If the tear is more significant, platelet-rich plasma therapy can be used in conjunction with surgery or physical therapy to improve outcomes. Talk to your doctor to learn more about the efficacy of platelet-rich therapy and whether it is right for you.

The Meniscus: A Crucial Component of the Knee Joint

The meniscus is a C-shaped piece of cartilage that sits between the thigh bone (femur) and shinbone (tibia) in the knee joint. It plays a vital role in knee function, providing shock absorption, joint stability, and lubrication.

Shock absorption

The meniscus acts as a cushion between the femur and tibia, absorbing the impact of everyday activities such as walking, running, and jumping. This helps to protect the bones and cartilage in the knee joint from wear and tear.

Joint stability

The meniscus helps to deepen the knee socket, which improves the stability of the joint. It also helps to distribute weight evenly across the knee joint, which reduces the risk of injury.

Lubrication

The meniscus produces a lubricating fluid that helps to keep the knee joint moving smoothly. This reduces friction and wear and tear on the bones and cartilage.

Other functions

In addition to its primary functions, the meniscus also plays a role in:

Proprioception (the ability to sense the position of the knee joint)
Nutrition of the articular cartilage
Prevention of hyperextension of the knee joint

Types Of Meniscus Injuries

Meniscal lesions and meniscus tears are two closely related terms. A meniscal lesion is any abnormality in the meniscus, the piece of cartilage that acts as a cushion between the bones of the knee joint. A meniscus tear is a specific type of meniscal lesion in which the meniscus is torn or ruptured.

Meniscal lesions can be caused by a variety of factors, including:

Trauma: A sudden injury to the knee, such as a fall or a twist, can cause the meniscus to tear.
Symptomatic degenerative meniscal lesions: The meniscus can degenerate over time, especially in older adults. This can make the meniscus more susceptible to tears.
Overuse: Repetitive stress on the knee, such as from running or jumping, can also lead to meniscal lesions.

Meniscus tears can be either partial or complete. A partial tear occurs when only a portion of the meniscus is torn. A complete tear occurs when the entire meniscus is torn. Before seeking treatment for your meniscal injuries, it's important to know the different types of tears and identify which one you might be suffering from. Meniscus repair can happen on its own, or it can require surgery, depending on which type of tear you have.

Horizontal Cleavage Tears

A horizontal cleavage meniscus tear is a knee injury that causes the meniscus to tear horizontally, or from side to side, across the joint. Horizontal cleavage meniscus tears often require surgery because the tear is located in a difficult-to-heal region of the meniscus and is often large and complex.

Symptoms:

Knee pain, especially when twisting or rotating the knee
Swelling and stiffness in the knee
Inability to fully straighten the knee
A catching or locking sensation in the knee
A popping or clicking sound in the knee
A feeling of instability in the knee

Bucket Handle Tears

A bucket handle meniscus tear is a severe knee injury in which the meniscus rips away from the back of the knee and flips forward like a bucket handle.

Symptoms:

Not being able to straighten the leg properly
Knee pain and locking
Hearing a pop when the injury occurs
Stiffness and swelling in the knee

A bucket handle tear is when the meniscus tears down the center, without splitting at the sides. It creates a hole in the meniscus that makes it look like a bucket handle. This type of tear is difficult to treat without meniscal repair surgery and is most common in young men.

Complex Tears

A complex meniscus tear is a severe tear in the knee cartilage that is often caused by a combination of factors, such as age, overuse, and injury.

Symptoms:

A popping sensation
Swelling and stiffness
Pain
Difficulty straightening the knee, rotating the leg, and placing weight on the affected leg.
Feeling your leg give way.

A complex meniscus tear increases the likelihood that you'll need a knee replacement in the future, and can seriously increase your chance of knee injury and osteoarthritis in the future.

Radial Tears

A radial meniscus tear is a horizontal tear in the cartilage that cushions the knee joint.

Symptoms:

Pain when twisting or rotating your knee
Difficulty straightening your knee
Feeling as though your knee is locked in place when you do straighten it

With a radial tear, the meniscus tears from the inner circle towards the outer circumference in a radial fan pattern. A radial tear can heal on its own with plenty of rest and some restorative treatments, but in severe cases can require meniscal repair surgery.

Oblique Tears

Oblique meniscus tears are a type of knee injury that can cause pain, swelling, and locking. They are often caused by sports injuries or overuse.

Symptoms:

Swelling and stiffness in the knee
Inability to straighten the knee fully
Pain when twisting or rotating the knee
Popping or clicking sound in the knee
Feeling like the knee is going to give out

When Should I Visit My Doctor If I Suspect a Meniscal Injury?

You should visit your doctor if you suspect a meniscus tear if you experience any of the following symptoms:

Severe pain in the knee, especially when twisting or rotating the knee
Swelling and stiffness in the knee
Inability to fully straighten the knee
A catching or locking sensation in the knee
A popping or clicking sound in the knee
A feeling of instability in the knee

These symptoms can also be caused by other knee problems, such as anterior cruciate ligament (ACL) injuries or knee osteoarthritis, so it is important to see a doctor to get a diagnosis and treatment plan.

Even if you have mild symptoms, it is still a good idea to see a doctor to rule out a meniscus tear and to get advice on how to manage your symptoms.

If you have a job or participate in activities that put a lot of stress on your knees, it is especially important to see a doctor if you suspect a meniscus tear. Early diagnosis and treatment can help to prevent further damage to the knee joint and improve your chances of a full recovery.

Here are some additional tips for when to see a doctor for a suspected meniscus injury:

If your knee pain is severe and does not improve with rest, ice, compression, and elevation (RICE).
If your knee is swollen and stiff, and you have difficulty moving it.
If your knee feels unstable or gives out on you.
If you have a catching or locking sensation in your knee.
If you hear a popping or clicking sound in your knee when you move it.
If you have any other concerns about your knee health.

If you are unsure whether or not you should see a doctor for a suspected meniscus injury, it is always best to err on the side of caution and schedule an appointment.

Platelet-rich Plasma (PRP) For Meniscal Tears

Platelet-rich plasma therapy is the injection of platelet-rich plasma (PRP) in an inflamed, injured, or scarred area to facilitate quick healing. This treatment is an option for treating meniscal lesions without surgical intervention or in conjunction with surgical intervention.

Platelet-rich Plasma Therapy Alone

PRP is used to help improve outcomes in meniscal lesions by:

Stimulating the production of new blood vessels and collagen in the torn meniscus
Reducing inflammation and pain
Promoting the healing of the meniscus tear

Platelet-rich plasma can be injected into meniscus injuries using a minimally invasive procedure. The procedure is typically performed as an outpatient surgery.

Platelet-rich plasma injections have been shown to be effective in improving pain and function in patients with meniscus tears. However, more research is needed to confirm the long-term efficacy and safety of platelet-rich plasma injections for this condition.

Here are some of the potential benefits of using platelet-rich therapy alone to help outcomes in meniscus injuries:

Reduced pain and inflammation
Improved function and range of motion
Shorter recovery time
Decreased risk of re-tear
Avoidance of surgery

Platelet-rich plasma injections are generally safe and well-tolerated. However, there are some potential risks associated with the procedure, such as infection, bleeding, and pain.

It is important to talk to your doctor about the risks and benefits of platelet-rich plasma (PRP) injections before deciding whether or not they are right for you.

Platelet-Rich Plasma PRP Therapy in Conjunction With Surgery

Platelet-rich plasma can be used in patients undergoing meniscus repair in a number of ways. One common approach is to inject PRP into the meniscus tear immediately after surgery. This can help to promote healing and reduce the risk of re-injury. Platelet-rich plasma can also be used to create a scaffold that can be used to support the meniscal tear during the healing process.

The use of Platelet-Rich Plasma (PRP) therapy in conjunction with meniscal repair can be performed in either arthroscopic or open surgery, depending on the surgeon's preference, the specific characteristics of the meniscal tear, and the patient's individual needs. The decision to use PRP with meniscal repair is influenced by factors such as the type and location of the tear, the patient's age and overall health, and the surgeon's expertise.

Here's how PRP therapy might be applied in both arthroscopic and open-surgical settings:

Arthroscopic Meniscus Repair with Platelet-Rich Plasma:
- Arthroscopic surgery is minimally invasive and is commonly used for meniscal repairs. In this approach, the surgeon inserts an arthroscope and specialized instruments through small incisions in the knee joint.
- PRP can be used in patients undergoing arthroscopic repair by injecting it into the injured area of the meniscus to potentially enhance the healing process.
- This combination of arthroscopic meniscal repair and PRP therapy is used when the surgeon believes it will benefit the patient based on the specific characteristics of the tear and the patient's condition.
Open Meniscal Repair with Platelet-rich Plasma:
- In some cases, open surgery may be necessary, typically for larger or more complex meniscal tears that cannot be effectively repaired arthroscopically.
- PRP can also be used in conjunction with open meniscal repair. The surgeon can apply platelet-rich plasma gel directly to the repair site to potentially support tissue healing. This gel can help to protect the tear and promote healing. Platelet-rich plasma can also be used to create a fibrin clot that can be used to seal the tear.

The choice between arthroscopic and open surgery for meniscus repair and the use of PRP will be determined by the surgeon's evaluation of the patient's condition and the characteristics of the meniscal tear. Both approaches can be effective when combined with platelet-rich plasma, but the decision will be made on a case-by-case basis to provide the best possible outcome for the patient.

Several studies have shown that platelet-rich plasma therapy can be effective in improving the outcomes of meniscal repairs. Overall, the evidence suggests that platelet-rich plasma is a promising new method to improve the outcomes of meniscus repair surgery.

Here are some of the potential benefits of using platelet-rich plasma in conjunction with surgery for meniscus repair:

Reduced pain and inflammation
Improved function
Reduced risk of re-injury
Faster healing time
Improved patient satisfaction

If you are considering surgery for a meniscal tear, talk to your doctor about the possibility of using platelet-rich plasma in conjunction with the surgery.

Preparation For PRP Treatment For Meniscus Repair

To prepare for PRP therapy, your doctor will likely give you specific instructions. However, there are some general guidelines that you should follow:

Eat a healthy diet and drink plenty of water. This will help to ensure that your blood is in good condition for PRP therapy.
Get enough sleep. Sleep is essential for healing, so it is important to be well-rested before your treatment.
Avoid taking over-the-counter (OTC) medications, aspirin, and paracetamol for at least 2 days before your appointment. These medications can thin your blood and make it more difficult to collect your platelets.
Avoid strenuous exercise for 24 hours before your treatment. Exercise can also thin your blood and make it more difficult to collect your platelets.
Tell your doctor about any illnesses that you have or any medications that you are taking. This includes prescription medications, vitamins, and herbal supplements.
Avoid smoking and drinking alcohol for at least 2 days before your treatment. Smoking and drinking alcohol can damage your blood cells and make PRP therapy less effective.

PRP Procedure For Meniscal Tears

Patients undergoing meniscal repair with platelet-rich plasma can expect a relatively straightforward procedure.

Day-of Patient Expectations for PRP Injections for Meniscus Repair

You will be asked to arrive at the doctor's office on time for your appointment.
Your doctor will draw your blood and prepare the PRP injections.
You will be positioned comfortably on an examination table.
Your doctor will inject the PRP injections into your knee joint.
You may experience some mild pain or discomfort during the injections.
After the injections, your doctor may apply ice and compression to your knee.
You will be given instructions on how to care for your knee at home.
You will be able to go home after the injections, but you will need to avoid driving for the rest of the day.

What Outcome Can I Expect With PRP Injections for Meniscus Repair?

Platelet-rich plasma (PRP) injections are a promising treatment for meniscus repair. PRP contains high concentrations of platelets, which are blood cells that contain growth factors. Growth factors are proteins that help to heal tissues.

PRP injections can be used in conjunction with surgery or as a standalone treatment for meniscus tears. Studies have shown that PRP injections can improve outcomes in both settings.

Outcomes of PRP injections in conjunction with surgery

Studies have shown that PRP injections can improve outcomes in patients who undergo surgery to repair a meniscus tear. For example, one study found that patients who received PRP injections in conjunction with surgery had less pain and swelling, and returned to their normal activities sooner, than those who received surgery alone.

Outcomes of PRP injections alone

PRP injections can also be used as a standalone treatment for meniscus tears. Studies have shown that platelet-rich plasma can be effective in reducing pain and improving function in patients with meniscus tears. However, it is important to note that PRP injections may not be as effective as surgery for repairing large or complex meniscus tears.

Overall, PRP injections are a promising treatment option for patients with meniscus tears. PRP injections can be used in conjunction with surgery or as a standalone treatment. Studies have shown that PRP injections can improve outcomes in both settings.

Takeaway: PRP Therapy for Meniscus Tears

Meniscus tears are a common injury, especially among athletes. The meniscus is a piece of cartilage that cushions the knee joint. A meniscus tear can cause pain, swelling, and stiffness in the knee.

When platelet-rich plasma is injected into the knee joint, it stimulates the growth of new cells and tissues, which can help to repair the meniscus tear. PRP injections are also effective at reducing pain and inflammation.

Advantages of PRP injections over surgery: