Bone marrow-derived fibrin clot is better source for menisca
Tears in the meniscus do not heal normally, often requiring surgery. Surgeons can draw fibrin, a protein involved in blood clotting, from peripheral blood (PB) or bone marrow aspirate (BMA), and implant a fibrin blood clot into the injured area to help with healing.

"There are various methods of meniscal repair that try to prevent re-tear" states the researcher, "but the re-tear rate still exceeds 20%." To see if BMA can bring this number down, the research team had to first understand the levels of growth factors involved in tissue repair found in BMA and then see the effects BMA-derived fibrin clots had when sutured into tissue during meniscal surgery.

Collecting bone marrow fluid and peripheral blood from five patients undergoing meniscal surgery, the team prepared fibrin clots for cytokine measurement.

Cell count evaluations found that BMA was more abundant in these growth factors than PB. Scientists have evaluated the clinical results of a meniscal repair using BMA-derived fibrin clots and found that rates of clinical and anatomic failure and re-tear were 10%, 6.7%, and 3.3% respectively—well below their PB counterpart.

As a two-year follow-up post-surgery, they examined pre- and post-operative clinical results and the healing rate of the meniscus in 30 cases of meniscal surgery that was combined with a BMA fibrin clot. MRI results showed significant improvements in the condition of the meniscus compared to the preoperative results and X-ray evaluation showed no significant progression of knee deformity.

"Our method of introducing BMA-derived fibrin clots into the injured area may become a treatment for meniscus injuries that until now have not been curable", said the author.

Arthroscopy: The Journal of Arthroscopic & Related Surgery
Source: https://doi.org/10.1016/j.arthro.2021.05.026
Dr. K S●●●●n R●j I●●●●●●l and 1 others like this
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