Publicly Available Rehabilitation Protocols Designated for Meniscal Repairs Are Highly Variable.

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Abstract

11. Knee Surg Sports Traumatol Arthrosc. 2026 Feb;34(2):436-444. doi: 10.1002/ksa.12685. Epub 2025 May 7. Current practice of biologic augmentation techniques to enhance the healing of meniscal repairs: A collaborative survey within the Meniscus International Network (MenIN) Study Group. Robinson J(1), Murray IR(2), Moatshe G(3)(4), Chahla J(5)(6), Tollefson LV(7), Parker DA(8), Familiari F(9)(10), LaPrade RF(7), DePhillipo NN(11); Meniscus International Network (MenIN) Study Group. Author information: (1)Knee Specialists, Bristol, UK. (2)Edinburgh Orthopaedics, University of Edinburgh, Edinburgh, UK. (3)Oslo Sport Trauma Research Center, Norwegian School of Sports Science, Oslo, Norway. (4)Orthopaedic Clinic, Oslo University Hospital Ullevål, Oslo, Norway. (5)Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. (6)Midwest Orthopaedics at Rush, Chicago, Illinois, USA. (7)Twin Cities Orthopedics, Edina, Minnesota, USA. (8)Sydney Orthopaedic Research Institute, Sydney, New South Wales, Australia. (9)Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Catanzaro, Italy. (10)Research Center on Musculoskeletal Health (MusculoSkeletalHealth@UMG), Magna Graecia University, Catanzaro, Italy. (11)Department of Orthopedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. PURPOSE: To evaluate practices and preferences among expert sports knee surgeons regarding biologic augmentation techniques in meniscal repair. METHODS: A 12-question multiple-choice survey was distributed to the Meniscus International Network (MenIN) Study Group. It covered biologic augmentation techniques for various meniscal tear types, both in isolation and with anterior cruciate ligament reconstruction (ACLR). Eight options were assessed: no augmentation, trephination, rasping, marrow venting, fibrin clot, platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC) and meniscal wrapping. Surgeons could select multiple techniques per scenario. RESULTS: Forty-two surgeons participated: 42% from Europe, 18% from North America, 10% from Latin America, 21% from Asia and 9% from Africa/Oceania. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons used at least one biologic augmentation technique. For meniscal tears associated with ACLR, 66% of surgeons used at least one biologic augmentation technique. The most utilized techniques were rasping (19%-69%), trephination (7%-43%), and marrow venting (0%-74%). PRP (2%-19%), BMAC (0%-14%) and meniscal wrapping (0%-10%) were least used. Biologic augmentation was most frequent for isolated radial (93%), isolated bucket-handle (86%), isolated vertical (86%) and isolated horizontal tears (98% for younger patients, 86% for degenerative tears). ACLR-associated repairs had lower augmentation rates, and meniscal root tears showed the highest percentage of non-augmented repairs. Over 50% of surgeons use a single augmentation technique, while 20% use two techniques depending on tear type. Overall, 33.3% (n = 14) of surgeons reported utilizing PRP and/or BMAC for meniscal repair augmentation, with the highest use observed in South America (12%) based on geographic usage. CONCLUSIONS: This survey provides insights into current meniscal repair practices among expert orthopaedic sports medicine surgeons. The findings reveal variability in approaches based on tear patterns and associated procedures, with a general preference for simpler mechanical augmentation techniques over more advanced biologics. For isolated meniscal tears (excluding meniscal root tears), 90% of surgeons in this cohort report using one or more biological augmentation techniques. LEVEL OF EVIDENCE: Level V, expert opinion. © 2025 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy. DOI: 10.1002/ksa.12685 PMCID: PMC12850556