Arthroscopic Repair of Radial Meniscal Tear Using Fibrin Clot Augmentation and "Hashtag" Style Inside-Out Technique.

Abstract

Significant meniscal injuries lead to pain and possible early osteoarthritis development. Fibrin clot augmentation represents an effective, cost-efficient method for improving healing rates in poorly vascularized meniscal tears. This arthroscopic technique shows fibrin clot augmentation combined with horizontal and vertical mattress sutures in a "ripstop" configuration for radial midbody medial meniscus tears. Thirty milliliters of autologous blood is collected and processed to form a fibrin clot, which is introduced inside-out through an endotracheal tube to optimize surface contact within the tear. The clot is secured with braided sutures while meniscal repair is performed using 2-0 polydioxanone sutures in a ripstop configuration. A similar technique may be used for any repair requiring biological augmentation. Rehabilitation protocols include 4 weeks of nonweight-bearing, followed by graduated weight-bearing to achieve full weight-bearing by 8 weeks. Range-of-motion restrictions vary by tear location. This technique provides a cost-effective, low-complexity technique for biological augmentation of repair of high-risk meniscus tears, potentially improving healing probability.