Meniscal repair using an exogenous fibrin clot. An experimental study in dogs.

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.