Anamnesi del paziente

For two yearsil paziente lamentava dolore al ginocchio destro, che si verificava durante la deambulazione e la flessione. Sotto carichi aumentati, l'articolazione si gonfiava e apparivano disturbi del sonno dovuti al dolore notturno. Negli ultimi due mesi prima della visita alla clinica MIBRAR, l'intensità del dolore è aumentata significativamente.

Previous conservative treatment (anti-inflammatory medication, physiotherapy) did not provide lasting improvement. A local orthopedist recommended arthroscopic meniscus resection — which the patient declined, seeking alternative treatment.

Diagnosi

Complex tear of the posterior horn of the medial meniscus of the right knee joint — visualized on MRI as a tear line extending into the meniscus body
Patellofemoral cartilage wear — thinning of the patellofemoral joint cartilage
Tibiofemoral cartilage wear — degenerative changes of the medial tibiofemoral compartment
Gonarthrosis grade I–II — early arthrotic changes with joint space narrowing

Rapporto operatorio — Metodo MIBRAR®

Procedure performed on 03.05.2017 at the MIBRAR clinic (Munich) under Prof. Dr. med. Arsen Babayan. Outpatient, under local anesthesia, without general anesthesia or hospitalization.

Intra-articular transplantation of autologous regenerative concentrates into the right knee joint cavity via microperforations
Intrameniscal transplantation — targeted injection of concentrates directly into the tear zone of the posterior horn of the medial meniscus
CGF (Concentrated Growth Factors) — concentrato arricchito con piastrine, fattori di crescita e fattori antinfiammatori, ottenuto dal sangue venoso del paziente
Lipogems® (microfragmented adipose tissue) — preparation with high concentration of regenerative substances, obtained from the patient's subcutaneous adipose tissue
Injection sites: medial meniscus and right knee joint space

RMN prima e dopo MIBRAR®

La RMN di controllo è stata eseguita 4 settimane dopo la procedura (30.05.2017). Tre coppie di immagini in diversi piani dello stesso paziente confermano: MIBRAR® fornisce rigenerazione completa del menisco — non cicatrizzazione, ma ripristino della struttura anatomica normale.

Knee MRI: posterior horn medial meniscus tear — before and 4 weeks after MIBRAR®

Images 1–2 (coronal slice): Left — posterior horn medial meniscus tear (green oval), cartilage wear. Right — 4 weeks after MIBRAR®: healed meniscal tissue, new cartilage layer.

Knee MRI sagittal: meniscus regeneration — before and 4 weeks after MIBRAR®

Images 3–4 (sagittal slice): Left — posterior horn meniscus tear line. Tibiofemoral cartilage degeneration. Right — cartilage layer restored, meniscus regenerated without resection.

MRI sagittal: posterior horn meniscus regeneration — before and 4 weeks after MIBRAR®

Images 5–6 (second sagittal slice): Left — tear zone in the posterior horn (green oval), condylar cartilage surface damage. Right — meniscus integrity restored, tear zone filled with new tissue.

Risultati del trattamento

After 1 week

Patient complaints completely ceased. Free movement without limitations — no limp, no crutches, no pain medication.

After 3 weeks

The patient resumed full sports activities without any limitations. Knee swelling did not recur, nighttime pain absent.

After 4 weeks

RMN di controllo (30.05.2017) confirmed full meniscus regeneration: healed tear tissue, new cartilage layer in the tibiofemoral compartment. Three slices in different planes rule out imaging artifacts.

A lungo termine

To this day, the patient has no complaints. Participates in sports, leads an active lifestyle without limitations. Arthroscopic resection, previously recommended, was not required.

Why MIBRAR® Instead of Arthroscopy

The standard approach for a complex posterior horn meniscus tear is arthroscopic partial meniscectomy (resezione della parte danneggiata). Tuttavia, la rimozione del tessuto meniscale porta alla ridistribuzione del carico nell'articolazione e allo sviluppo accelerato dell'artrosi: secondo le meta-analisi, fino al 50% dei pazienti dopo meniscectomia necessita di sostituzione articolare entro 15 anni.

The MIBRAR® method is fundamentally different: instead of removing damaged tissue — stimulating its regeneration con concentrati autologhi CGF e Lipogems®. I fattori di crescita dalle piastrine innescano la proliferazione dei condrociti, mentre le cellule staminali mesenchimali dal tessuto adiposo si differenziano in cellule meniscali e cartilaginee.

In this case, the result is particularly indicative: full meniscus regeneration in 4 weeks — confirmed by three MRI slices — without resection, without arthroscopy, without hospitalization. The patient returned to sports in 3 weeks, while arthroscopy rehabilitation takes 6–8 weeks.