半月板修复术中应用纤维蛋白支架可提高愈合率及功能预后：一项系统综述
简介
本系统综述纳入15项研究、438例半月板撕裂患者（多为无血供区），评估纤维蛋白支架（包括外周静脉血纤维蛋白凝块、骨髓抽吸浓缩物纤维蛋白凝块、富血小板纤维蛋白及其联合富血小板血浆）对半月板修复的增强作用。关键发现：外周静脉血纤维蛋白凝块组完全愈合率77.5%，部分愈合率12.2%，失败率10.3%；并发症发生率8.2%（感觉异常、再损伤），持续膝痛2.6%；I…
英文摘要
BACKGROUND: Biologic augmentation techniques, such as fibrin-based scaffolds, have been proposed to enhance healing of meniscal tears, particularly in avascular zones. However, clinical outcomes remain variably reported. STUDY DESIGN: Systematic review; Level of evidence, 4. PURPOSE: To evaluate the healing rate, complication rate, and patient-reported outcome scores after meniscal repair augmented with fibrin-based scaffolds. METHODS: A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed, Embase, and Ovid MEDLINE through October 15, 2025. Studies evaluating fibrin-based augmentation during meniscal repair were included. Primary outcomes were healing and complication rates. Secondary outcomes included International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores. RESULTS: Of 757 studies, 15 met inclusion criteria, comprising 438 patients with meniscal tears in mostly avascular zones. Of these, 345 underwent fibrin-based augmentation; the rest did not. There were 4 fibrin-based methods identified: fibrin clot from peripheral venous blood (FC-PVB; n = 252), fibrin clot from bone marrow aspirate concentrate (FC-BMAC; n = 30), platelet-rich fibrin (PRF; n = 15), and PRF combined with platelet-rich plasma (PRF+PRP; n = 48). Among patients who received FC-PVB, 77.5% achieved complete healing, 12.2% partial healing, and 10.3% failure. Complications occurred in 8.2% of patients who received FC-PVB and included paresthesia and reinjuries; 2.6% reported persistent knee pain. In FC-PVB studies, significant improvements were seen in IKDC and Lysholm scores but not in Tegner scores. Other fibrin-based methods showed consistent improvements across all scores. Compared to nonaugmented repair, fibrin-based augmentation yielded superior outcomes. CONCLUSION: Fibrin-based augmentation demonstrated high healing rates, low complication rates, and improved clinical outcome scores. Compared to nonaugmented repair, fibrin-based scaffolds achieved better healing and function. FC-PVB enhanced symptom relief and functional recovery, while only FC-BMAC showed improvements in activity levels.