患者病史

For two years患者主诉右膝关节疼痛，行走和弯曲时出现。在增加负荷下关节肿胀，因夜间疼痛出现睡眠障碍。在访问MIBRAR诊所前的最后两个月，疼痛强度显著增加。

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.

诊断

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

手术报告 — MIBRAR®方法

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疗法F (Concentrated Growth Factors) — 富含血小板、生长因子和抗炎因子的浓缩物，取自患者静脉血
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

MIBRAR®前后MRI对比

术后4周进行了复查MRI（2017.05.30）。同一患者三个不同平面的三对图像证实：MIBRAR®实现了半月板完全再生——不是瘢痕化，而是正常解剖结构的恢复。

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.

治疗结果

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

复查MRI (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.

长期

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 （切除损伤部分）。然而半月板组织切除导致关节内负荷重新分布和加速退行性变发展：根据荟萃分析，半月板切除后高达50%的患者在15年内需要关节置换。

The MIBRAR® method is fundamentally different: instead of removing damaged tissue — stimulating its regeneration 使用自体CGF和Lipogems®浓缩物。血小板中的生长因子触发软骨细胞增殖，而脂肪组织中的间充质干细胞分化为半月板和软骨细胞。

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.