Summary

Treatment of degenerative meniscal lesions with percutaneus, ultrasound guided PRP injections seems to be safe and efficient in selected cases.

Abstract

Introduction

Degenerative meniscal lesions can be found in 60% of population after the age of 65 years. Most of them are localized in medial meniscus and are stable and asymptomatic. These lesions are always only a part of other degenerative knee changes. Noninvasive treatment includes physiotherapy and NSAID’s. Knee arthroscopy, debridement, partial meniscectomy are invasive treatments that are usually performed. Meniscectomy seems not to be the best solution due to acceleration of degenerative changes in cartilage and subchondral bone in the following years after meniscectomy. There can be other option of more biological treatment of stable meniscal lesions ?- needling and injecting PRP into the lesion under Ultrasound guidance.

Material&Method
Our study includes 71 patients with painful degenerative meniscal lesions treated with ultrasound guided needling and PRP injection. There were 50 males and 21 females. Mean age 45 years (21 to 66). Mean volume PRP 3,5 ml. We have used validated double spin Cursan method to reach mean 5-6 x concentration of platelets.

Results

Results of the procedure are based on a subjective manner and are gathered on follow up visits or through other various ways of contact with patients. After average 12 months of follow up 53% patients had improvement, this includes 18% with little pain and 35% with no pain after procedure. 47% of patients had no effect during the follow up time. 30% of patients required further invasive treatment.

Conclusion

Ultrasound guided needling and PRP injections can be the reasonable next step of treatment in cases of stable, symptomatic degenerative meniscal lesions.