Marc Darrow MD,JD

Even before it became more challenging to get a meniscus tear surgery, people contacted me to see if our treatments of stem cell therapy and platelet rich plasma therapy could help them avoid arthroscopic knee surgery. More questions came from the people who were told that they would need total removal of the meniscus or meniscectomy.

I am going to focus this article on the use of Platelet Rich Plasma injections for meniscus tears and repairs. For stem cell therapy, please see my companion article: Stem cell therapy for meniscus tears.

Here is a research study from August 2019 (1), In the introduction of the study, the research team introduced its readers to the understanding of how Platelet Rich Plasma injections can help people with meniscus tears.

“Platelet-rich plasma (PRP) is an autologous concentration of platelets that contain a large number of growth factors. These growth factors play a role in the regeneration, repair, and acceleration of the biochemical process, thereby reducing the pain associated with injuries of the articular cartilage and meniscus.”

Before I get to the study’s findings, here is a brief explanation of the growth factors in PRP and what they do:

PRP treatments involve collecting a small amount of your blood and spinning it in a centrifuge to separate your platelets from your red blood cells. The collected platelets are then injected back into the injured knee to stimulate healing and regeneration.

The platelets contain the following healing agents, or “growth factors.”

  • Platelet-derived growth factor (PDGF) is a protein that helps control cell growth and division, especially blood vessels. When more blood (and the oxygen it carries) is delivered to the site of a wound, there is more healing.
  • Transforming growth factor beta (or TGF-β) is important in tissue regeneration.
  • Insulin-like growth factors are signaling agents. They help change the environment of the damaged joint from diseased to healing by “signaling” the immune system to start rebuilding tissue.
  • Vascular endothelial growth factor (VEGF) is an important protein that brings healing oxygen to damaged tissue where blood circulation might be damaged or inadequate.
  • Epidermal growth factor plays a key role in tissue repair mechanisms.

In the research study I mentioned above, the doctors evaluated the effectiveness of PRP injections in 126 patients with loss of cartilage and meniscus tears in their knees.

  • Three treatments were given.
  • The researchers concluded: “The results showed considerable improvement 3 months after the PRP application, and 6 months after the application the results remained approximately identical.” At 6 months the benefits were apparent.

A study from March 2020 (2) examined the effectiveness of PRP in degenerative meniscal tears of the knee. This study included 10 patients with meniscus tear but without knee osteoarthritis. This was a single treatment with follow up at 3 months and 6 months.

  • Of the 6 patients who regularly participated in sports were able to recover competition or training.
  • In seven patients who underwent MRI follow-up at 6 months, MRI showed stability of the meniscal tears

The doctors were able to conclude of this study: “Intra-meniscal administration of PRP under ultrasound guidance directly into meniscal degenerative lesions is feasible and safe.”

The demand for non-surgical options in people over 50 because the surgery may not work

Many of my new patients have come in for treatment because they want to continue walking the golf course, play tennis every other day, or, need to be on the worksite. When they get a surgical consult for a meniscus tear, they are told that arthroscopic partial meniscectomy for someone over 50 is controversial. This means that may not help or it may help for a short-term and this may lead them into a cascade of further surgeries. This was explained in a August 2019 study.(3)

In this study the hypothesis that people over 50, IF they had degenerative meniscus tears and knee osteoarthritis (a developing bone on bone situation) would benefit from an arthroscopic partial meniscectomy more so than a patient, over the age of 50, who only had a meniscus tear. Not so. According to the researchers there was no meaningful differences in patient satisfaction or clinical outcomes between patients with traumatic and degenerative tears and no or mild osteoarthritis. Also women, people who were obese, or people who had outer or lateral meniscus tears were less likely to be happy about their surgery.

PRP after meniscus surgery

Most of the time when someone contacts me about PRP after meniscus surgery it is usually about one of three things.

  1. The patients needs to play, tryout, participate in a sport and needs to get back quickly
  2. The patient needs to be functioning better at the worksite
  3. The surgery did not go that well

Can PRP accelerate healing after an arthroscopic meniscus repair? It depends on the type of surgery. If the meniscus was repaired with suture and little tissue was removed during the procedure, PRP will most probably be beneficial. If the arthroscopic surgery was a total meniscectomy, then we have to have a realistic expectation of what we are trying to do with the treatment. PRP will not regrow meniscus tissue if there is no meniscus left. PRP can help rebuild the remaining meniscus fragment to an extent. It can help repair it, but it cannot regenerate the “other half,” that was cut out.

PRP can be effective in helping stabilize and strengthening the other components of the knee to help accelerate healing after surgery. These would be the ligament and tendon attachments as well as the articular cartilage.

A study from September 2020 (4) looked at the benefits of PRP after a meniscus surgery. Here the suggestion was that while the clinical efficacy of platelet-rich plasma (PRP) as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury remains controversial. The findings of this meta-analysis suggest that PRP injection can effectively enhance the efficacy of arthroscopic repair of meniscal injury, reduce the failure rate and severity of pain, and improve active flexion.

Do you have questions? Ask Dr. Darrow

A leading provider of stem cell therapy, platelet rich plasma and prolotherapy

PHONE: (800) 300-9300 or 310-231-7000

Stem cell and PRP injections for musculoskeletal conditions are not FDA approved. We do not treat disease. We do not offer IV treatments. There are no guarantees that this treatment will help you. Prior to our treatment, seek advice from your medical physician. Neither Dr. Darrow, nor any associate, offer medical advice from this transmission. This information is offered for educational purposes only. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate. We do not guarantee the accuracy, completeness, usefulness or adequacy of any resource, information, product, or process available from this transmission. We cannot be responsible for the receipt of your email since spam filters and servers often block their receipt. If you have a medical issue, please call our office. If you have a medical emergency, please call 911.


1 Mitev K, Longurov A. Intra-articular platelet-rich plasma injections for treating knee pain associated with articular cartilage and degenerative meniscal lesions. Open access Macedonian journal of medical sciences. 2019 Aug 15;7(15):2484.
2 Guenoun D, Magalon J, de Torquemada I, Vandeville C, Sabatier F, Champsaur P, Jacquet C, Ollivier M. Treatment of degenerative meniscal tear with intrameniscal injection of platelets rich plasma. Diagnostic and Interventional Imaging. 2020 Mar 1;101(3):169-76.
3 Lizaur-Utrilla A, Miralles-Muñoz FA, Gonzalez-Parreño S, Lopez-Prats FA. Outcomes and patient satisfaction with arthroscopic partial meniscectomy for degenerative and traumatic tears in middle-aged patients with no or mild osteoarthritis. The American journal of sports medicine. 2019 Aug;47(10):2412-9.
4 Wang Y, Yao C, Yang Z, Guo W. Clinical efficacy of platelet-rich plasma as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury. Journal of International Medical Research. 2020 Sep;48(9):0300060520955059.

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