Year: 2026 | Month: April | Volume: 13 | Issue: 4 | Pages: 716-729
DOI: https://doi.org/10.52403/ijrr.20260471
Biologic Augmentation in Arthroscopic Meniscal Surgery: A Systematic Review and Meta-Analysis
Ida Bagus Giri Sena Putra1, Erwin Saspraditya2, I Kadek Yuris Wira Artha3
1Faculty of Medicine, Warmadewa University, Bali, Indonesia
2,3Department of Orthopaedic and Traumatology, Siloam Hospital Denpasar, Bali, Indonesia
Corresponding Author: Ida Bagus Giri Sena Putra
ABSTRACT
Background: Meniscal tears are among the most frequent causes of knee dysfunction and arthroscopic intervention. Despite advances in surgical technique, limited intrinsic vascularity continues to constrain meniscal healing. Biologic augmentation using platelet-rich plasma (PRP) or bone marrow aspirate concentrate (BMAC) has emerged as a potential strategy to enhance tissue regeneration and postoperative recovery; however, clinical evidence remains inconsistent.
Objective: To evaluate the effects of biologic augmentation—specifically PRP and BMAC—on functional and structural outcomes following arthroscopic meniscal surgery.
Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. PubMed, Cochrane Library, and ScienceDirect databases were searched up to October 2025 for comparative studies investigating PRP or BMAC in meniscal repair or partial meniscectomy. The primary outcome was surgical failure or revision rate, while secondary outcomes included KOOS–Sport, KOOS–Quality-of-Life (QOL), and other validated functional scores. Pooled mean differences (MD) and risk ratios (RR) were calculated using random-effects models.
Results: Four comparative studies with a total of 2,502 menisci were included. Biologic augmentation significantly improved functional outcomes compared with control or placebo. The pooled MD for KOOS–Sport was +11.06 (95% CI 8.03–14.10, p < 0.00001, I² = 16%), and for KOOS–QOL was +10.82 (95% CI 3.28–18.36, p = 0.005, I² = 64%). No significant reduction was observed in revision or failure rate (RR = 0.63, 95% CI 0.27–1.46, p = 0.28, I² = 54%). No severe adverse events were reported.
Conclusion: Biologic augmentation using PRP or BMAC during meniscal surgery significantly enhances postoperative functional recovery and quality of life, with consistent improvements exceeding clinically meaningful thresholds. While revision risk remains unchanged, these therapies provide safe and effective adjunctive options for accelerating recovery. Further high-quality trials with standardized biologic protocols are required to confirm long-term structural benefits and refine patient selection criteria.
Keywords: Meniscal repair; Platelet-rich plasma; Bone marrow aspirate concentrate; Biologic augmentation; Arthroscopy; Regenerative medicine; Meta-analysis.
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