Robinson James, Murray Iain R, Moatshe Gilbert, Chahla Jorge, Tollefson Luke V, Parker David A, Familiari Filippo, LaPrade Robert F, DePhillipo Nicholas N
Knee Specialists, Bristol, UK.
Edinburgh Orthopaedics, University of Edinburgh, Edinburgh, UK.
Knee Surg Sports Traumatol Arthrosc. 2025 May 7. doi: 10.1002/ksa.12685.
To evaluate practices and preferences among expert sports knee surgeons regarding biologic augmentation techniques in meniscal repair.
A 12-question multiple-choice survey was distributed to the Meniscus International Network (MenIN) Study Group. It covered biologic augmentation techniques for various meniscal tear types, both in isolation and with anterior cruciate ligament reconstruction (ACLR). Eight options were assessed: no augmentation, trephination, rasping, marrow venting, fibrin clot, platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC) and meniscal wrapping. Surgeons could select multiple techniques per scenario.
Forty-two surgeons participated: 42% from Europe, 18% from North America, 10% from Latin America, 21% from Asia and 9% from Africa/Oceania. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons used at least one biologic augmentation technique. For meniscal tears associated with ACLR, 66% of surgeons used at least one biologic augmentation technique. The most utilized techniques were rasping (19%-69%), trephination (7%-43%), and marrow venting (0%-74%). PRP (2%-19%), BMAC (0%-14%) and meniscal wrapping (0%-10%) were least used. Biologic augmentation was most frequent for isolated radial (93%), isolated bucket-handle (86%), isolated vertical (86%) and isolated horizontal tears (98% for younger patients, 86% for degenerative tears). ACLR-associated repairs had lower augmentation rates, and meniscal root tears showed the highest percentage of non-augmented repairs. Over 50% of surgeons use a single augmentation technique, while 20% use two techniques depending on tear type. Overall, 33.3% (n = 14) of surgeons reported utilizing PRP and/or BMAC for meniscal repair augmentation, with the highest use observed in South America (12%) based on geographic usage.
This survey provides insights into current meniscal repair practices among expert orthopaedic sports medicine surgeons. The findings reveal variability in approaches based on tear patterns and associated procedures, with a general preference for simpler mechanical augmentation techniques over more advanced biologics. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons in this cohort report using one or more biological augmentation techniques.
Level V expert opinion.
评估专业运动膝关节外科医生在半月板修复中对生物增强技术的应用情况和偏好。
向半月板国际网络（MenIN）研究小组发放了一份包含12个问题的多项选择题调查问卷。该问卷涵盖了各种半月板撕裂类型的生物增强技术，包括单独使用以及与前交叉韧带重建（ACLR）联合使用的情况。评估了八个选项：不进行增强、钻孔、锉磨、骨髓减压、纤维蛋白凝块、富血小板血浆（PRP）、骨髓抽吸浓缩物（BMAC）和半月板包裹。外科医生可以针对每种情况选择多种技术。
42名外科医生参与了调查：42%来自欧洲，18%来自北美，10%来自拉丁美洲，21%来自亚洲，9%来自非洲/大洋洲。对于孤立的半月板撕裂（不包括半月板根部撕裂），90%的外科医生至少使用一种生物增强技术。对于与ACLR相关的半月板撕裂，66%的外科医生至少使用一种生物增强技术。使用最多的技术是锉磨（19%-69%）、钻孔（7%-43%）和骨髓减压（0%-74%）。PRP（2%-19%）、BMAC（0%-14%）和半月板包裹（0%-10%）使用最少。生物增强在孤立的放射状撕裂（93%）、孤立的桶柄状撕裂（86%）、孤立的垂直撕裂（86%）和孤立的水平撕裂（年轻患者中为98%，退变撕裂中为86%）中最为常见。与ACLR相关的修复的增强率较低，半月板根部撕裂未增强修复的比例最高。超过50%的外科医生使用单一的增强技术，而20%根据撕裂类型使用两种技术。总体而言，33.3%（n = 14）的外科医生报告在半月板修复增强中使用了PRP和/或BMAC，根据地域使用情况，南美洲的使用率最高（12%）。
本调查提供了对专业骨科运动医学外科医生当前半月板修复实践的见解。研究结果表明，根据撕裂模式和相关手术，方法存在差异，总体上更倾向于使用更简单的机械增强技术而非更先进的生物制剂。对于孤立的半月板撕裂（不包括半月板根部撕裂），该队列中90%的外科医生报告使用了一种或多种生物增强技术。
V级专家意见。
