Martinkėnienė Viktorija Brogaitė, Austys Donatas, Brazaitis Andrius, Makulavičius Aleksas, Aukštikalnis Tomas, Dockienė Ilona, Verkauskas Gilvydas
Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Department of Children's Orthopedics and Traumatology, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania.
Medicina (Kaunas). 2025 Sep 7;61(9):1616. doi: 10.3390/medicina61091616.
The menisci are crucial fibrocartilaginous structures of the knee joint and have to be repaired in case of a tear. However, not all meniscal tears heal, even in young patients. Fibrin clot (FC) started to be used to reduce the failure rates following meniscus repair. The purpose of this study is to evaluate and compare outcomes after isolated arthroscopic meniscal repair augmented with FC versus without FC. Fifty-nine patients aged under 19 with isolated meniscal tears were randomized into two groups: one group underwent the meniscal repair with FC (FC-augmented), and the other group did not receive FC (control). The evaluation and comparison between the groups based on FC augmentation included secondary arthroscopy rates, patient-reported outcome measures (Pedi-IKDC, Lysholm, and Tegner), and clinical and radiological (MRI) assessments at a median follow-up of 12 months. No statistically significant difference was observed between FC-augmented and control groups in Pedi-IKDC, Lysholm, and TAG scores, or following clinical and radiological (MRI) evaluation. Patients in the FC-augmented group reported fewer clinical symptoms at the final follow-up across unstable and demanding (bucket-handle and complex) tear type subgroups ( = 0.012 and 0.041, respectively). Overall, nine revision arthroscopies occurred in both groups (2 and 7, respectively), all across bucket-handle and complex tears with no significant difference between the FC-augmented and control groups ( = 0.072). This pilot study found that FC usage during meniscal repair reduces clinical symptoms for patients with unstable, bucket-handle, or complex meniscal tears at the final follow-up of 12 months postoperatively. Nonetheless, no statistically significant differences were observed within the other outcome measures between the FC-augmented and control groups and subgroups based on meniscal tear types. Level of evidence: Level II.
半月板是膝关节重要的纤维软骨结构，撕裂时需进行修复。然而，即便在年轻患者中，并非所有半月板撕裂都能愈合。纤维蛋白凝块（FC）开始被用于降低半月板修复后的失败率。本研究旨在评估和比较单纯关节镜下半月板修复联合FC与不联合FC的疗效。59例19岁以下单纯半月板撕裂患者被随机分为两组：一组接受联合FC的半月板修复（FC增强组），另一组未接受FC（对照组）。基于FC增强对两组进行评估和比较，内容包括二次关节镜检查率、患者报告的结局指标（儿童国际膝关节文献委员会评分、Lysholm评分和Tegner评分）以及在中位随访12个月时的临床和影像学（MRI）评估。在儿童国际膝关节文献委员会评分、Lysholm评分和TAG评分方面，以及在临床和影像学（MRI）评估中，FC增强组和对照组之间未观察到统计学上的显著差异。在最终随访时，FC增强组患者在不稳定及复杂（桶柄状和复合型）撕裂类型亚组中报告的临床症状较少（分别为P = 0.012和0.041）。总体而言，两组均发生了9例翻修关节镜手术（分别为2例和7例），均为桶柄状和复合型撕裂，FC增强组和对照组之间无显著差异（P = 0.072）。这项初步研究发现，半月板修复术中使用FC可在术后12个月的最终随访中减轻不稳定、桶柄状或复杂半月板撕裂患者的临床症状。尽管如此，在其他结局指标方面，FC增强组与对照组以及基于半月板撕裂类型的亚组之间未观察到统计学上的显著差异。证据级别：II级。
