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Review
. 2025 Dec 9:73:62-71.
doi: 10.1016/j.jor.2025.12.015. eCollection 2026 Mar.

Platelet rich plasma augmentation for meniscus repair reduces failure but not complication rates or outcomes: A systematic review and meta-analysis

Udit Dave  1 , Jared Rubin  2 , Nicole Chang  2 , Nurudeen Alli  3 , Myles Atkins  3 , Thomas E Moran  3 , Andrew S Bi  3 , Monique Haynes  3 , Nikhil N Verma  3 , Jorge Chahla  3
Affiliations
Review

Platelet rich plasma augmentation for meniscus repair reduces failure but not complication rates or outcomes: A systematic review and meta-analysis

Udit Dave et al. J Orthop. .

Abstract

Introduction: Platelet rich plasma (PRP) has been shown to promote healing, especially in areas with poor vascularity, such as the inner third of the meniscus. The purpose of this systematic review and meta-analysis was to compare post-operative outcomes and complications among patients who have undergone meniscus repair with and without PRP augmentation.

Methods: In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library databases were searched in December 2024 for studies published after 2004. Studies met inclusion criteria if they included patients who underwent meniscal repair without concomitant procedures and were comparative studies evaluating outcomes in patients who underwent meniscal repair with and without PRP treatment. Studies not written in English or not directly comparing patients undergoing meniscus repair with and without PRP were excluded. Two-proportion z-tests were performed to assess for a statistically significant difference in the proportion of each complication within the PRP cohort versus the control cohort. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool for RCTs and MINORS criteria for non-RCTs.

Results: The initial search identified 862 studies, of which 8 were included, each with sufficiently low risk of bias. A total of 354 patients were included with 180 patients in the PRP cohort and 174 patients in the control cohort. Mean age across cohorts ranged from 26.0 to 70.0 years. Mean follow-up times ranged from 3.0 to 48.0 months. Similar mean values were reported in patient-reported outcomes including Lysholm, VAS, IKDC, and WOMAC scores across both cohorts. Patients undergoing meniscus repair with PRP augmentation had significantly fewer re-tears/failures (18.2 %) than patients undergoing repair without PRP augmentation (30.5 %), (p = 0.0188); however, there was no significant difference in rate of re-operations, wound complications, or infection between the two cohorts.

Conclusions: While significant heterogeneity in study methodology exists within the comparative literature, limited evidence exists suggesting a significantly decreased rate of re-tear or failure in patients undergoing meniscus repair with PRP augmentation versus without PRP augmentation.

Level of evidence: Level III, Systematic Review and Meta-Analysis of Level I-III studies.

Keywords: Biologic healing enhancement; Knee; Meniscus; Platelet rich plasma; Systematic review and meta-analysis.

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Conflict of interest statement

N.N.V. declares the following financial interests/personal relationships which may be considered as potential competing interests: Abbot Laboratories: Hospitality payments; American Orthopaedic Society for Sports Medicine: Board or committee member; American Shoulder and Elbow Surgeons: Board or committee member; Arthrex, Inc: IP royalties; Research support; Arthroscopy Association of North America: Board or committee member; Axonics Inc: Hospitality payments; Boston Scientific Corporation: Hospitality payments; Breg: Research support; Foundation Fusion Solutions LLC: Hospitality payments; Graymont Professional Products IP LLC: IP Royalties; IBSA Pharma Inc: Hospitality payments; Medacta USA Inc: Paid Consultant; Medwest Associates; Educational support; Nalu Medical Inc: Hospitality payments; Nevro Corp: Hospitality payments; Orthofix Medical inc: Hospitality payments; Ossur: Research support; Pacira Pharmaceuticals Incorporated: Hospitality payments; Relievant Medsystems Inc: Hospitality payments; Salix Pharmaceuticals: Hospitality payments; SLACK Incorporated: Editorial or governing board; Smith & Nephew: IP royalties; Research support; Spinal Simplicity LLC: Travel and Lodging; Stryker: IP royalties; Paid consultant; Research support; Vericel Corporation: Hospitality payments; Vertos Medical Inc: Hospitality payments. J.C. declares the following financial interests/personal relationships which may be considered as potential competing interests: American Orthopaedic Society for Sports Medicine: Board or committee member; Arthrex, Inc: Paid consultant; Arthroscopy Association of North America: Board or committee member; Breg Inc: Hospitality payments; CONMED Linvatec: Paid consultant; DePuy Synthes Sales inc: Hospitality payments; International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member; Joint Restoration Foundation Inc: Hospitality payments; Medical Device Business Services Inc: hospitality payments; Midwest Associates: Educational Support; Ossur: Paid consultant; Pacira Pharmaceuticals Incorporated: Hospitality payments; RTI Surgical Inc: Paid consultant; SI-Bone Inc: Hospitality payments; Smith & Nephew: Paid consultant; Paid presenter or speaker; Vericel Corporation: Paid consultant, hospitality payments. Each of the other authors declare that they have no competing interests.

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