P218 - PRP Injection is Not Associated with a Decrease in Time to Meniscectomy: Matched Insurance Database Analysis
- E. Berlinberg (Chicago, US)
- E. Berlinberg (Chicago, US)
- E. Forlenza (Chicago, US)
- M. Moore (New York, US)
- H. Patel (Chicago, US)
- J. Chahla (Chicago, US)
- B. Forsythe (Chicago, US)
Abstract
Purpose
Platelet-rich plasma (PRP) may serve as a nonoperative treatment option for meniscal tears. This study examines how PRP therapy affects time to and rate of meniscectomy in patients with meniscal tears.
Methods and Materials
A large insurance database was queried for patients with CPT code for a meniscus tear between 2015-2018. Groups were stratified by PRP, corticosteroid injection (CSI), or no injection preoperatively. Cohorts were matched by age, gender, Charlson Comorbidity Index, and comorbid osteoarthritis. The primary outcome was rate of meniscectomy. Secondary outcome was time to meniscectomy.
Results
583 matched patients received PRP, CSI, or no injection. Despite matching on CCI, there were baseline differences in rates of COPD (187 patients [32.1%] in the PRP group, 171 patients in the CSI group [29.3%], and 137 patients [23.5%] in controls, P=0.004) and rheumatoid arthritis (35 patients [6.0%] in the PRP group, 32 patients [5.5%] in the CSI group, and 14 patients [2.4%] in controls, P=0.007). 408 (70.0%) patients in the PRP group vs. 331 patients (56.8%) in the CSI group and 228 (39.1%) controls underwent meniscectomy (P<0.001). No difference in time to meniscectomy was observed between groups (PRP: median 42 days [IQR 18-167]; CSI: median 39 days [IQR 19-90]; no injection: 29 [IQR 12-65] days, P = 0.866). In PRP patients, significant predictors of meniscectomy included age (adj-OR=0.979, 95% CI 0.962-0.996, P=0.018), complex tear type (adj-OR=2.517, 95% CI 1.500-4.357, P<0.001), other/unspecified tear type (adj-OR=2.155, 95% CI 1.205-3.916, P=0.010), and both a medial and lateral-sided tear (adj-OR=4.232, 95% CI 1.586-11.643, P=0.004).
Conclusion
Patients with a PRP injection were more likely to undergo meniscectomy than patients with CSI or no injection preoperatively. PRP did not significantly delay time between diagnosis of meniscus tear and surgery. Patients with younger age, complex tears, other/unspecified tears, and both medial and lateral tears were more likely undergo meniscectomy despite a PRP injection.