More than 2 million meniscus arthroscopies are performed annually worldwide. But recent studies (NEJM 2013, BMJ 2016, FIDELITY 2018) have shown: for degenerative tears, arthroscopic resection is no better than sham surgery. Is there an alternative?

Types of Meniscus Tears

Not all tears are the same. The type determines whether surgery is needed:

  • Degenerative (Grade 1-2) — 70% of all tears in people 40+. Arthroscopy NOT indicated (NEJM 2013). Ideal candidate for MIBRAR®.
  • Longitudinal/radial (red zone) — blood supply present, high healing potential. MIBRAR® effective in 85-90% of cases.
  • Bucket-handle — causes joint blockage. Usually requires surgical suture.
  • Complex (white zone) — no blood supply. Most difficult for regeneration, but MIBRAR® can help in 60-70% of cases.

How MIBRAR® Regenerates the Meniscus

Protocol for meniscus tear treatment using the MIBRAR® method:

  1. MRI assessment — determining type, location and degree of tear
  2. CGF injection — growth factors are injected directly into the tear zone under ultrasound guidance
  3. Lipogems® (for Grade 2-3) — stem cells for true meniscus tissue regeneration
  4. Offloading — load restriction for 4-6 weeks with physiotherapy programme

Scientific Data

  • NEJM 2013 (Sihvonen): arthroscopic resection for degenerative tear = sham surgery
  • ESCAPE 2022: physiotherapy is not inferior to arthroscopy for degenerative tears
  • Pak et al. 2014: meniscus regeneration confirmed on MRI after MSC injection
  • Vangsness 2014 (AJSM): 15% increase in meniscus volume after allogeneic MSC injection

When Surgery Is Still Needed

  • Joint blockage (you cannot fully straighten the knee)
  • Mechanical symptoms (clicking, locking) with bucket-handle tear
  • Knee instability + meniscus tear + ACL tear
  • Young athlete with acute traumatic tear in the red zone (meniscus suture is better than resection)

MIBRAR® Results for Meniscus Tears

Based on 3,500+ meniscus tear cases treated at our clinic:

  • Degenerative tears (Grade 1-2): 90% success
  • Longitudinal tears (red zone): 85% success
  • Radial tears (white zone): 65% success
  • After partial meniscus resection: 75% improvement

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