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Autologous Platelet-Rich Fibrin Matrix–Augmented Repair for Parameniscal Cysts: Surgical Technique


ABSTRACT: Parameniscal cysts are defined as an internal disorder of the knee joint. It is known that parameniscal cysts are associated with horizontal meniscal tears that could lead to the collection of synovial fluid within the cyst. Despite the treatment of meniscal tears, cyst recurrence is still an issue that needs to be addressed. In this regard, there has been an increasing interest in the use of biologic agents to enhance the vascularity and healing of the meniscus. Preliminary results for biologic therapeutic agents, such as growth factors, bone marrow, and aspirate concentrate, have been encouraging. However, these options are more demanding in regards to time, financial burden, resources, and so on. Autologous platelet-rich plasma is readily available, easy to use, affordable, and minimally invasive. This Technical Note will describe a step-by-step and reproducible technique for the harvesting, preparation, and use of an autologous platelet-rich fibrin matrix used to augment the healing of meniscal repairs. Technique Video Video 1 The video depicts the treatment of an anterolateral parameniscal cyst associated with a complex meniscal tear on the right knee. A 33-year old man suffered a knee injury while skiing. The magnetic resonance imaging of the knee shows a considerable anterolateral parameniscal cyst. The kit used to prepare the membrane consists of a system which extracts a blood sample from the peripheral site of the patient, separates the platelet-rich plasma (PRP) and transfers the PRP into a recipient. The membrane is obtained by high speed centrifugation of a small quantity of PRP. The operative (right) leg is sterilized in the standard fashion. The parameniscal cyst, joint line, patella, and patellar tendon are marked with a sterile skin-marker. Standard anteromedial and anterolateral portals are placed and a diagnostic arthroscopy is performed. Viewing from the anteromedial portal in 4-position, the horizontal tear of the lateral meniscus is probed to evaluate its stability. Due to the characteristics of the tear, neither stitches nor meniscectomy were performed. An 18-gauge needle is used under arthroscopic vision to locate the exact point of the meniscal tear and parameniscal cyst on the skin. An oblique skin incision is made in correspondence with the cyst. A Z-shaped incision is made on the tensor fascia latae in order to get to the meniscocapsular junction. The cyst is then evacuated and carefully removed. Finally, the autologous platelet-rich fibrin matrix is harvested by a side-to-side suture in the inner layer of the meniscocapsular junction.

SUBMITTER: Screpis D 

PROVIDER: S-EPMC8556611 | biostudies-literature |

REPOSITORIES: biostudies-literature

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