Use of Fibrin Clot in the Knee

Fibrin has been used in medicine for nearly 100 years and the use of fibrin clots have been used in meniscal repairs for over 20 years. It is theorized that the concentrated levels of platelets in fibrin clot aid in healing through the release of growth factors. The use of concentrated platelets has gained recent popularity through the increase use of platelet-rich plasma; however, it is still unknown what platelet concentration constitutes an optimal level of healing. Recent studies on the healing of the anterior cruciate ligament (ACL) reconstruction and repair suggest that concentrated platelets might play a role in advanced healing in the ACL. This article will summarize the history of fibrin clots in surgery, the biochemistry of platelets, current use, and the future of fibrin clots as biological aids in healing. Techniques for preparing an exogenous clot, repairing meniscal tears with a fibrin clot, and the use of fibrin clots in ACL reconstruction will also be discussed.

Keywords: anterior cruciate ligament reconstruction, biological healing, double-bundle, fibrin clot, meniscus repair