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Meniscus Tear: PRP and MFAT Offer Unique Benefit

By Samuel G Oltman, ND, RMSK


Are surgery and physical therapy (PT) really your only options for a meniscus tear? Meniscus tears are a very common injury with a surprisingly level of uncertainty in how to best treat them. PRP and MFAT provide a unique benefit that when deployed strategically within a detailed workup and plan, can have an enormous beneficial effect on knee health and function.


What Is The Meniscus?

The meniscus is made from very tough and dense fibrocartilage. It acts as a shock absorber in the knee to distribute forces more evenly. Healing the meniscus after an injury is difficult because it has very poor blood flow, making it susceptible to ongoing pain and degeneration. This lack of blood flow and circulation is a common thread in orthopedic injuries and is one of the reasons why PRP and MFAT work: they concentrate a healing and circulatory response in these low-blood-flow tissues.


Goals of Meniscus Tear Treatment

When you have a painful meniscus tear there are two primary goals of treatment: Reduce inflammation and prevent osteoarthritis. A secondary goal is to heal the tear. We know that healing the tear is not necessary because many tears are never painful. What creates pain is the inflammatory reaction to the damaged tissue. PRP and MFAT address both of these primary goals and give you a reasonably good chance at the secondary goal of meniscus healing, which no other available treatment does.

Surgery can reduce pain by taking out the inflammatory trigger but causes trauma and can lead to long term degeneration, which is why it’s been shown to be no better than PT or placebo/sham surgery at 12+ months for certain tears (1,2,3).

Cortisone can reduce pain in the short term by suppressing inflammation but undercuts your body’s healing response, leading to re-injury risk and faster degeneration.


PRP and MFAT Offer Unique Benefit

The inflammatory trigger is addressed effectively by PRP and MFAT. Patients are consistently able to do more with less pain without the downside risk of their knee degrading faster. This is accomplished by the ability of PRP and MFAT to alter the inflammatory response in the joint to be more anabolic (build up), rather than catabolic (break down) (4).

Arthritis prevention, or treatment of current arthritis, is the other aspect that PRP and MFAT address like no other treatment can. Meniscus tears increase your risk of developing arthritis (5). Keeping the cartilage you have is a primary goal of joint health. Whether you already have arthritis or just are at risk for it because of a meniscus tear, PRP and MFAT are your best options for maintaining joint and cartilage health.


Reversing The Tear?

Healing the meniscus tear is possible but not necessary. There are many studies, and my own clinical experience, demonstrating that PRP and MFAT can result in full or partial healing of a meniscus tear, confirmed with MRI (6). The reason it’s not totally necessary is that we don’t need perfect tissue to be pain free. Simply improving the tear can result in complete pain relief and full function. Any meniscus tear healing with PRP and MFAT is icing on the cake and provides a proof of concept that these treatments provide a unique benefit. Healing the tear won’t happen with everyone, but it doesn’t need to for you to feel better.

Importantly, PRP and MFAT can also be used in conjunction with or after these other options. You did a year of PT and still have symptoms? PRP and MFAT may be able to help. You did surgery and still have pain? PRP and MFAT may be able to help (7).


There Are More Options Than You Think

You have more options than just PT, cortisone, and surgery. PRP and MFAT provide a distinctly beneficial approach that addresses the root inflammatory cause, can heal the tissue, and may prevent the primary risk factor: osteoarthritis. If you are continually hampered by a meniscus tear, see us today at Cascade Regenerative Medicine to see if you’re a good candidate for PRP and MFAT. Our care fills the large gap that exists between PT and surgery, and there’s nowhere where that is more needed than in meniscus tears.



References:

  1. Skou ST, Hölmich P, Lind M, et al. Early surgery or exercise and education for meniscal tears in young adults. NEJM Evidence. 2022;1(2).

  2. Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368(18):1675-1684.

  3. Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013;369(26):2515-2524.

  4. Medina-Porqueres I, Martin-Garcia P, Sanz-De-Diego S, et al. Clinical and functional outcome of meniscal injuries treated with platelet-rich plasma: a single-center case series. Int J Environ Res Public Health. 2022;19(12):7118.

  5. Khan HI, Aitken D, Ding C, et al. Natural history and clinical significance of meniscal tears over 8 years in a midlife cohort. BMC Musculoskeletal Disorders. 2016;17(1):4.

  6. Orthobiologic injections for treating degenerative meniscus lesions: a matter of facts? Ten years of clinical experience in a systematic review. Journal of Cartilage & Joint Preservation. 2023;3(2):100104.

  7. Li Z, Weng X. Platelet-rich plasma use in meniscus repair treatment: a systematic review and meta-analysis of clinical studies. Journal of Orthopaedic Surgery and Research. 2022;17(1):446.

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