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The Journal of Bone and Joint Surgery, Vol 70, Issue 8 1209-1217, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Meniscal repair using an exogenous fibrin clot. An experimental study in dogs
SP Arnoczky, RF Warren and JM Spivak
Laboratory of Comparative Orthopaedics, Hospital for Special Surgery, New York, N.Y. 10021.
To evaluate the ability of a fibrin clot to stimulate and support a
reparative response in the avascular portion of the meniscus,
two-millimeter-diameter full-thickness lesions in the avascular portion of
the medial meniscus of twelve adult dogs were filled with an exogenous
fibrin clot that had been prepared from each animal. The healing response
was then examined using histology and autoradiography with 35SO4 at
intervals from one week to six months. The defects that had been filled
with a fibrin clot healed through a proliferation of fibrous connective
tissue that eventually modulated into fibrocartilaginous tissue. The fibrin
clot appeared to act as a chemotactic and mitogenic stimulus for reparative
cells and to provide a scaffolding for the reparative process. The origin
of these reparative cells was not determined in this study, but they were
thought to arise from the synovial membrane as well as the adjacent
meniscal tissue. Control defects remained empty. While the reparative
tissue was grossly and histologically different from the normal adjacent
meniscal tissue, it was morphologically similar to the reparative tissue
that was previously observed in the vascular area of the meniscus. CLINICAL
RELEVANCE: The ability of an exogenous fibrin clot to stimulate and support
a reparative response in the avascular portion of the meniscus may
represent a potential method of avascular meniscal repair.
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