Treatment of horizontal dissection of the knee menisci with platelet-rich plasma (PRP). Literature review and analysis of own data

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Abstract

BACKGROUND: Treatment of damage to the inner layer of the meniscus of the knee joint that does not extend to the articular surface remains an open question. Subsequently, these injuries can cause a complete rupture of the meniscus that already requires surgical treatment. Existing methods of treatment at this stage of meniscus injury have not shown their effectiveness.

AIM: Study the effect of platelet-rich plasma (PRP) on meniscus regeneration.

MATERIALS AND METHODS: The analysis of the 15 patients treatment results with the PRP method, which effectively stimulates regenerative processes, was carried out. The effectiveness of the method was assessed using the following evaluation scales: visual analog scale (VAS), Lequesne scale, WOMAC index (Western Ontario and McMaster Universities Osteoarthritis Index), Lysholm scale, KSS scale (Knee Society Score) and magnetic resonance imaging (MRI).

RESULTS: According to the results of MRI performed after 6 months, there was no progression of meniscus damage after PRP therapy by all parameters.

CONCLUSION: The study showed an improvement in all rating scales. In addition, according to MRI data, after 6 months there was no progression of the degenerative process in the menisci. The presented method can be the first step in the treatment of this pathology.

About the authors

Mikhail P. Lisitsyn

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: lissitsyn@rambler.ru
SPIN-code: 7162-0145

MD, PhD, Dr. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Moscow

Ruslan Y. Atlukhanov

Hospital of the Tsentrosoyuz of the Russian Federation

Author for correspondence.
Email: ruslan.atl@mail.ru
ORCID iD: 0000-0003-3417-6744
SPIN-code: 6845-8768

MD, traumatologist-orthopedist

Russian Federation, Moscow

Adam M. Zaremuk

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: adamzaremuk@mail.ru
ORCID iD: 0000-0002-6630-9735
SPIN-code: 4169-3882

MD, PhD, Cand. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Moscow

Ekaterina M. Lisitsyna

Guta Clinic

Email: lis10@yandex.ru
ORCID iD: 0000-0002-5184-2561
SPIN-code: 7268-0320

MD, traumatologist-orthopedist

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Knee joint structure: 1 — anterior cruciate ligament; 2 — posterior cruciate ligament; 3 — articular cartilage; 4 — internal lateral ligament; 5 — external lateral ligament; 6 — medial meniscus; 7 — lateral meniscus; 8 — tibia; 9 — fibula; 10 — femur; 11 — patella

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3. Fig. 2. Knee meniscus ligaments: 1 — posterior cruciate ligament; 2 — tribal collateral ligament; 3 — medial meniscus; 4 — anterior cruciate ligament; 5 — patellar ligament; 6 — transverse ligament of knee; 7 — posterior meniscofemoral ligament; 8 — tribiofibular joint, superior tribiofibular joint; 9 — fibular collateral ligament; 10 — head of fibula; 11 — lateral meniscus

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4. Fig. 3. The histological structure of the meniscus: a — meniscus view from above (1 — white zone; 2 — red zone; 3 — border (red-white) zone; b — meniscus view in cross section (1 — vessels; 2 — parallel oriented fibers; 3 — radially oriented fibers; 4 — surface layer cells; 5 — chondrocyte-like cells; 6 — fibroblast-like cells

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5. Fig. 4. The introduction of the needle into the meniscus under ultrasound control (the arrow indicates the needle)

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6. Fig. 5. MRI of the patient before the platelet-rich plasma (PRP) procedure

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7. Fig. 6. MRI of the patient 6 months after the platelet-rich plasma (PRP) procedure

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