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Author Topic: Effect of PRP on degenerate meniscus tear  (Read 308 times)

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Offline silver_maple

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Effect of PRP on degenerate meniscus tear
« on: August 26, 2021, 11:05:35 PM »
Hi all, quick update after a second MRI. Caucasian male, 51, in good shape.

Dec. 2019: MRI (1.5 Tesla) shows degenerate meniscus tear in the medial meniscus, right knee, affecting the posterior horn (white area). No broken pieces. Generalized mild chondromalacia patella. Mild crepitus. No significant pain, typically in the range of 0-1 on a 0-10 scale. Full ROM.

Over the next 18 months had six (6) leukocyte-poor PRP shots in the knee, 5x-6x platelet concentration, 5ml per shot. Harvest centrifuge.

Aug. 2021: Second MRI (3.0 Tesla) on same knee. The MRI showed degenerate meniscus tear in the medial meniscus affecting the posterior horn. No broken pieces. Generalized mild chondromalacia patella. The crepitus persists at the same level. Same 0-1 pain level, full ROM.

Conclusion: Six shots of LP-PRP over 18 months did nothing to heal a degenerate meniscus tear or improve chondromalacia patella.

Level of evidence: low - single individual case study (IV or lower).

If anyone has had non-operative success in at least partially restoring a degenerate meniscus tear I am all ears.
2019 - Chondromalacia patella gr 1-2, both knees; early bilateral tibio-femoral arthritis; 5mm focal chondral lesion (LK); degenerate meniscus tear (RK)
2020 - PRP x3 in RK
2021 - PRP x3 in RK, PRP x1 in LK

Offline vickster

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Re: Effect of PRP on degenerate meniscus tear
« Reply #1 on: August 27, 2021, 02:01:28 PM »
Not sure there’s anything that can stop meniscus degeneration in the first place or stop it getting worse, just a fact of ageing ultimately. We’re not really designed to live as long as we do! Meniscus can degenerate from age 30 so you could be 20 years into the process (I know mine was already toast when first scoped at 38).

I don’t think there’s any hard evidence that PRP does anything for degenerate cartilage where the blood flow is poor

You could avoid activities that cause inflammation in the joint (like hard impact sports), keep the joint nourished with non weight bearing stuff like swimming, cycling.  Could maybe move to a plant based and an anti inflammatory diet, limit, sugar, wheat etc, add in turmeric, fish oils etc, ensure your vitamin D levels are normal etc.
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline SuspectDevice

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Re: Effect of PRP on degenerate meniscus tear
« Reply #2 on: August 28, 2021, 11:02:07 AM »
I know of people with meniscus tears who have healed it just by being careful & not pushing it.  One who is now back to running after we discussed my meniscus trim & I advised him to wait at least 12mths before resorting to surgery which he did.

I had PRP for my PFPS and don't think it helped at all.

Recently started taking collagen powder however & I'm fairly confident it has had a positive effect on my knee cartilage (meniscus, patella, chaffed section on my femur) & other arthritic joints (thumbs, wrists, big toes).
L Medial menisectomy 2012
PFPS both knees 2012-2017
Pre-CRPS diagnosed 2014 (I think this was crap)
2017 - 90+% cured via Dr Dye's research
2018 - MTB crash, busted collarbone & ribs - easy compared to knees!
2021 - ride 3x/week, swim 2x/week, gym 2x/week, short runs 2x/week, back to short races

Offline silver_maple

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Re: Effect of PRP on degenerate meniscus tear
« Reply #3 on: August 29, 2021, 12:07:50 AM »
Solid advice, Vickster, thank you. I discontinued high impact in late 2018. I've been generally sticking to biking (2 x 30 min a week), swimming (2 x 45 min a week), gentle walking (3km - 6km, 5-7x a week) plus some upper body exercises. Increased salmon intake (2-4 x a week) displacing some meat but haven't yet given up meat completely. Vitamin D is on my to do list to check.

Suspect, good to hear from you again. I've read all your posts here plus your story on the tri site. Your grit and perseverance are amazing.

The main objective of my PRP therapy was to neutralize inflammation and in that it was successful. As the red area of the meniscus is able to heal (if it's not pushed), I held out some faint hope that PRP could induce some healing in the white area; that was a secondary, aspirational, objective. As reported, it did not happen. Unfortunately I am not able to read MRI images to try to detect if there has been any marginal change one direction or another. My sports doc would not pour over the images, he just looks at the radiologist's report.

Dosage is important in medicine. Theoretically speaking, could weekly PRP for 2 years induce degenerate meniscus healing? I don't know and to the best of my knowledge it has not been tried. I have no intention to pursue this.

In any case, thought it would be useful to report this negative result documented by MRIs. I would like to encourage more people to do that, acknowledging MRIs are not perfect, but do offer some objectivity. May continue with the occasional PRP to control inflammation, as needed; would like to stay away from NSAIDs. Haven't decided whether to try some stem concoction; if I do may report.
2019 - Chondromalacia patella gr 1-2, both knees; early bilateral tibio-femoral arthritis; 5mm focal chondral lesion (LK); degenerate meniscus tear (RK)
2020 - PRP x3 in RK
2021 - PRP x3 in RK, PRP x1 in LK















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