Fibrin clot delivery system for meniscal repair

Abstract

As meniscal preservation particularly in younger active individuals with a symptomatic meniscal tear remains the preferred treatment option, various methods have been suggested to increase healing and success rates after meniscal repair. The recent increase in clinical use of platelet rich plasma has contributed to the increased use of fibrin clot, which virtually has the same healing property. However, despite the relative ease of acquisition and preparation of fibrin clots, delivering it to the desired target area arthroscopically is challenging. Therefore, we report with a pertinent literature review a novel method of planting a fibrin clot to the desired area of meniscal tear arthroscopically using our delivery system to enhance healing.

Keywords: Fibrin clot; Meniscus; Meniscus repair; Meniscus tear.

Fig. 1

Autologous blood (50-60 mL) is placed in a sterile 200 mL beaker and is gently hand stirred with a stir rod for 5 to 10 minutes.

Fig. 2

The fibrin clot is removed from the beaker and placed on sterile gauze.

Fig. 3

(A) An eighteen-gauge needle is passed through the plastic cannula to the desired site penetrating the skin. (B) After passing the wire loop through, the 18-gauge needle is removed and the sutured fibrin clot is passed through the loop.

Fig. 4

(A) By gently pulling the suture with the aid of a plastic pusher, the fibrin clot is passed through the plastic cannula. (B) The fibrin clot is planted into the desired intraarticular site.