Gentle method

Without surgery: gluing meniscus tears with stem cells

Tears in the meniscus or cruciate ligament are among the most common knee injuries.

(Bild: Wellnhofer Designs - stock.adobe.com)

An advanced therapy for meniscus and ligament tears in the knee saves many patients from having to undergo surgery. The tear is glued with a special tissue adhesive (fibrin glue) and the body's own stem cells, allowing it to grow back together. 

"We have recently started offering our patients a very advanced therapy for meniscus and ligament tears in the knee. This is a particularly gentle method of tissue regeneration," reports Priv.-Doz. Dr. Patrick Weninger, orthopaedist and trauma surgeon in Vienna. 

The torn structure can be glued using a special fibrin glue. In addition, the body's own stem cells are used to help the tissue heal. The procedure is performed under local anesthesia and can also be performed without surgery.

First, blood is taken from the patient, which is then centrifuged to obtain stem cells and platelet-rich plasma, as Dr. Weninger explains. Weninger explains. The knee specialist then visualizes the tear in the meniscus or ligament as part of an ultrasound examination and fills it in a controlled manner and under sterile conditions with a so-called fibrin glue, also known as tissue glue. The edges of the tear are sealed.

The fibrin glue serves as a scaffold or matrix, so to speak, and ensures that the stem cells actually remain where they are supposed to heal the tissue.

Priv.-Doz. Dr. Patrick Weninger, Orthopäde und Unfallchirurg

Bild: Daniel Kleinfercher/Apace Media

Immediately afterwards, the stem cells are injected into the adhesive. "This serves as a scaffold or matrix, so to speak, and ensures that the cells actually remain where they are supposed to heal the tissue," says Doz. Weninger. 

While the adhesive holds the tear together, the stem cells ensure that it heals and closes. This process takes around six weeks and can even take place in areas of the meniscus that are poorly supplied with blood, as the orthopaedic surgeon explains further. 

Doz. Weninger: "The procedure is particularly suitable for tears at the base of the meniscus and for smooth tears without flap formation. However, it does not work for basket handle tears or tears of the meniscus that become trapped in the joint space, for which arthroscopy is necessary. However, the method also works very well for tears of the anterior/posterior cruciate ligament and tears of the medial collateral ligament. In many cases, it is only possible without surgery under ultrasound control and local anesthesia."

Is there an age limit for patients to undergo this procedure? Doz. Weninger answers in the negative: "There is no age limit. I even recommend it for older patients in particular, as there is no risk of anesthesia. In addition to the knee, we routinely use this method for torn ankle ligaments. No immobilization is required and weight can be placed on it immediately."

The knee specialist has already treated 43 patients in this way over the past six months and is more than convinced by the procedure. Dr. Weninger's clinics are currently conducting a large study to prove the long-term effect of the fibrin glue and stem cells.