Ultrasound-guided injection using leucocyte-rich platelet-rich plasma for treatment of meniscal injuries in a duathlete: a case report
Author: Jeimylo C de Castro There is a paucity of data regarding using platelet-rich plasma therapy for Baker’s cyst-associated medial meniscal tear. To date, conservative treatments for this type of condition include aspiration of fluid effusion with steroid injection and physical therapy. When this treatment fails, arthroscopic debridement, meniscectomy, cyst decompression and open cystectomy are available surgical management options. Recurrence rates, however, are high such that even these procedures fail to provide long-term pain relief. This case study explores the benefits of leukocyte-rich platelet-rich plasma therapy in treating tears in the posterior horn of the medial meniscus with concomitant Baker’s cyst. With limited studies available, this case hopes to encourage more studies to be done in the future to provide a conservative option for patients with similar cases.Plain Language Summary
Aim: To describe the successful treatment of fluid-filled cyst-associated ligament tear using ultrasound-guided injection of enhanced regenerative blood. Setting: Outpatient clinic. Patient: 60-year-old male with right knee pain. Case description: The patient presented with a 4-month history of right knee pain. Exam revealed restriction and pain during knee bending. Imaging showed swelling in both the front and back of the knee. The patient underwent four weekly enhanced PRP treatments. Results: The patient reported near-complete pain resolution with MRI showing reduction of swelling in the aforementioned areas. Patient was also able to complete a marathon.Conclusion: This enhanced PRP may be considered as a treatment option for patients with Baker’s cyst-associated meniscal injuries.
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Baker’s cyst develops when excess fluid from the synovial cavity moves through a one-way valve connection between the synovial cavity of the knee joint and the semimembranosus tendon-medial head of the gastrocnemius muscle bursa.
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The treatment and management of Baker’s cyst may be divided into surgical and non-surgical approaches. Typical non-surgical options may include physical therapy, activity modification and ultrasound-guided aspiration and injection using steroid solution and platelet-rich plasma therapy are also available for pain control and meniscal healing.
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Although MRI remains the gold standard for diagnosis, ultrasound is a viable alternative in diagnosing this condition due to its portability and dynamic features.
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This case describes a clinically successful use of leucocyte-rich platelet-rich plasma (LR-PRP) therapy under ultrasound guidance for Baker’s cyst-associated meniscal injuries.
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LR-PRP allows for a targeted approach to inject multiple growth factors at the injury site to further augment the healing process.
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There is a lack of studies on the effectiveness of platelet-rich plasma therapy for meniscal tear-associated Baker’s cyst are limited and thus further robust research is needed.
