Association Between Lesion-Directed Positioning Management and Early Functional Recovery Following PRP-Augmented Meniscal Repair: A Retrospective Cohort Study

Abstract Background Platelet-rich plasma (PRP) serves as a biological augment for meniscal repair; however, evidence regarding strategies to optimize the local retention and distribution of PRP at the repair site in the postoperative period remains scarce. Postoperative positioning protocols administered by nursing personnel may modulate the gravitational distribution of PRP at the repair site and consequently influence early functional recovery, yet this hypothesis has not been investigated. This study aimed to evaluate the association between nurse-led, lesion site–directed positioning and early patient-reported outcomes following PRP-augmented arthroscopic meniscal repair. Methods This single-center retrospective cohort study included 53 consecutive patients who underwent arthroscopic meniscal repair supplemented with intra-articular PRP injection at the conclusion of surgery between April 2024 and January 2025. Patients were stratified into a directed positioning group (n = 23) or a conventional positioning group (n = 30) based on whether a lesion site–directed positioning protocol was implemented postoperatively. Primary outcomes included the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner activity level score, and Numeric Rating Scale (NRS) pain score assessed at 1, 3, and 12 months postoperatively. Postoperative complications and reoperations were also documented. This study was reported in accordance with the STROBE guidelines. Results Baseline demographic characteristics, meniscal tear morphology and location, and preoperative patient-reported outcome measures were comparable between groups. The directed positioning group exhibited significantly superior IKDC and Lysholm scores at 1 and 3 months postoperatively compared with the conventional positioning group (both P < 0.05). At 3 months, the directed positioning group also demonstrated a significantly higher Tegner activity level score and a significantly lower NRS pain score (both P < 0.05). By 12 months postoperatively, no statistically significant between-group differences were detected in any of the outcome measures (all P > 0.05). No cases of surgical site infection, deep vein thrombosis, or arthrofibrosis necessitating arthroscopic lysis of adhesions were recorded in either group, and no patient underwent reoperation. Conclusions In patients undergoing PRP-augmented arthroscopic meniscal repair, nurse-led lesion site–directed positioning was associated with improved patient-reported functional outcomes during the first 3 postoperative months and reduced pain at 3 months. Given its low cost, ease of implementation, and feasibility of independent execution by nursing staff, this positioning strategy warrants integration into orthopedic nursing practice; nevertheless, its clinical efficacy necessitates confirmation through well-designed prospective trials.