Leukocyte-poor platelet-rich plasma to treat degenerative meniscal tear: A case report

Abstract

A traumatic and/or degenerative meniscus lesion is thought to be a clinical manifestation of early-onset osteoarthritis (OA), which is a chronic progressive condition that can cause substantial pain and disability. Platelet-rich plasma (PRP) is an emerging treatment option that has been reported to improve healing. Here, we present a case of a 29-year-old woman, with left anterior and medial knee pain, without history of trauma or injury. The patient was managed with leukocyte-poor PRP injections derived from her peripheral blood with high concentrations of platelets, platelet-derived growth factors, and bioactive proteins, with a total follow-up of 30 months. Post-treatment patient was evaluated at every follow-up for improvement using three independent measures, VAS, GROC, and KOOS. There was considerable improvement in the pain symptoms from baseline (VAS: 70 mm; GROC: n/a; and KOOS: 39) to 30 months (VAS: 40 mm; GROC: 5; and KOOS: 63.1) indicating that PRP injections can serve as therapeutic intervention for treatment of pain associated with early onset of OA. To further validate these results, more longitudinal and evidence-based studies are recommended, which may further guide the clinicians to manage early-onset OA with PRP.

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

“…Moreover, a recent case report described the efficacy of PRP in a patient with a grade 3a medial meniscus tear. These patients were followed for 30 months after treatment and reported significant improvement in pain symptoms from baseline (VAS score = 70 mm; Global Rating of Change [GROC] score not available; KOOS score = 39) to 30 months (VAS score = 40 mm; GROC score = 5; and KOOS score = 63.1) . More recently, a double‐blinded randomized controlled trial was performed using PRP to augment direct meniscal repair of vertical longitudinal tears.…”

Examination of the Role of Platelet-Rich Plasma in Meniscal Tears

“…The literature search yielded 6 articles. [14][15][16][17][18][19] Most articles comprised active patients with a mean age of 28 to 29 years. The articles include case studies, 1 retrospective cohort study, and 1 longitudinal cohort study.…”

“…20 The GROC score evaluates a patient's perception of improvement before the date of injury and after treatment, and the Tegner Activity Level Scale assesses knee function, including limping, support, instability, stair climbing, and squatting. 20 Betancourt et al 14 detailed a case study of a 29-year-old woman with a grade 3a medial meniscus tear confirmed on magnetic resonance imaging. She had pain with weight bearing, clicking, squatting, and changing positions from seated to standing and had previously tried hyaluronic acid injections.…”

“…Results from this article showed an improvement in VAS, GROC, and KOOS pain scores at a 30-month follow-up; specifically, VAS improved from 70 mm to 40 mm, and KOOS improved from 39 to 63.1. 14 Griffin et al, 15 in a retrospective cohort study, evaluated the use of PRP in arthroscopic meniscal repair in subsequent meniscectomy and functional outcome measures, including IKDC, Tegner Lysholm Knee Scoring Scale, return to work, and return to sport. Over the course of 3 years, surgeons performed arthroscopic meniscus repairs on 35 patients, of which 15 were performed with PRP augmentation.…”

Intra-Articular Implantation of Stromal Vascular Fraction Plus Platelet Rich Plasma in a Degenerative Meniscal Injury

“…Several groups have reported on the use of PRP in meniscal injuries. Betancourt and Murrell reported on a case study with the use of a single PRP injection in a degenerative meniscus lesion with considerable improvement in pain symptoms [34].…”