Henning (1990) reports outcomes of 153 arthroscopic meniscal repairs augmented with exogenous fibrin clot injection and, for complex tears, a fascia sheath. The study addresses whether biological augmentation improves healing rates across isolated and ACL-associated tears. Key questions include the impact of time from injury to surgery and tear complexity on outcomes.
When you see a young patient with a meniscal tear and intact or reconstructed ACL, this paper is why you reach for repair rather than resection. Before Henning's series, isolated meniscal repairs had a 41% failure rate with rasping alone — high enough that many surgeons defaulted to partial meniscectomy.
The practical rules this paper established: repair ACL-associated tears within 8 weeks of injury (1.5% failure) and do not wait. Delays beyond 8 weeks drive failure to 20%. For isolated tears, always inject fibrin clot; failure drops from 41% to 8%.
For complex tears (double longitudinal, radial splits, broken-handle patterns), add a fascia sheath over the repair site with the clot injected beneath it. Failure drops from 22% to 11% with this addition. The contraindications are worth memorizing: stable tears under 10 mm, partial-thickness tears under 50% of vertical height, and radial tears 3 mm or less in depth do not require repair.
Henning (1990) reports outcomes of 153 arthroscopic meniscal repairs augmented with exogenous fibrin clot injection and, for complex tears, a fascia sheath. The study addresses whether biological augmentation improves healing rates across isolated and ACL-associated tears. Key questions include the impact of time from injury to surgery and tear complexity on outcomes.
When you see a young patient with a meniscal tear and intact or reconstructed ACL, this paper is why you reach for repair rather than resection. Before Henning's series, isolated meniscal repairs had a 41% failure rate with rasping alone — high enough that many surgeons defaulted to partial meniscectomy.
The practical rules this paper established: repair ACL-associated tears within 8 weeks of injury (1.5% failure) and do not wait. Delays beyond 8 weeks drive failure to 20%. For isolated tears, always inject fibrin clot; failure drops from 41% to 8%.
For complex tears (double longitudinal, radial splits, broken-handle patterns), add a fascia sheath over the repair site with the clot injected beneath it. Failure drops from 22% to 11% with this addition. The contraindications are worth memorizing: stable tears under 10 mm, partial-thickness tears under 50% of vertical height, and radial tears 3 mm or less in depth do not require repair.