Joan C Monllau1, Francesco Poggioli2, Juan Erquicia2, Eduardo Ramírez3, Xavier Pelfort4, Pablo Gelber5, Raúl Torres-Claramunt6. 1. Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain. 2. Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain. 3. Orthopaedic Department, Hospital de Sant Pau, Universitat Autònoma, Barcelona, Spain. 4. Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain; Orthopaedic Department, Consorci Sanitari de l'Anoia, Barcelona, Spain. 5. Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain; Orthopaedic Department, Hospital de Sant Pau, Universitat Autònoma, Barcelona, Spain. 6. Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain. Electronic address: rtorresclaramunt@parcdesalutmar.cat.
Abstract
PURPOSE: To report the magnetic resonance imaging (MRI) and clinical outcomes at a minimum 5-year follow-up in a series of patients with postmeniscectomy syndrome and treated with a polyurethane scaffold. METHODS: All consecutive patients operated on from September 2008 to February 2011 for either persistent medial or lateral joint line compartmental pain receiving a polyurethane scaffold due to a previous partial meniscus resection with a minimum 5-year follow-up were included. Functional scores (Knee Injury and Osteoarthritis Outcomes Score, International Knee Documentation Committee, Lysholm, and Tegner) were assessed preoperatively and at the last follow-up. The state of the scaffold as well as postoperative scaffold extrusion and the total remaining meniscal volume was also evaluated in MRI. RESULTS: Thirty-two patients were included. The mean follow-up was 70.8 ± 7.5 months. The functionality of the knees improved in all the scores used (P < .001) except for the Tegner score that stayed steady. Most of meniscal implants showed extrusion of 2.4 mm (95% confidence interval [CI], 1.1-3.7) were smaller and a hyperintensity signal was seen in the MRI. Three scaffolds were resorbed at the last follow-up. The meniscal volume, determined by MRI, was 1.14 cm3 (95% CI, 0.96-1.31) preoperatively and 1.61 cm3 (95% CI, 1.43-1.7) at the last follow-up. No differences were presented. CONCLUSIONS: The use of a polyurethane meniscal scaffold in patients with a symptomatic meniscus deficit had a good functional outcome at 5 years after surgery. However, the implanted scaffolds did not present normal meniscal tissue with MRI, and the implant volume was considerably less than expected. The fact that most of patients included received different concomitant procedures during scaffold implantation introduces a degree of performance bias into the results. LEVEL OF EVIDENCE: Level IV, case series.
PURPOSE: To report the magnetic resonance imaging (MRI) and clinical outcomes at a minimum 5-year follow-up in a series of patients with postmeniscectomy syndrome and treated with a polyurethane scaffold. METHODS: All consecutive patients operated on from September 2008 to February 2011 for either persistent medial or lateral joint line compartmental pain receiving a polyurethane scaffold due to a previous partial meniscus resection with a minimum 5-year follow-up were included. Functional scores (Knee Injury and Osteoarthritis Outcomes Score, International Knee Documentation Committee, Lysholm, and Tegner) were assessed preoperatively and at the last follow-up. The state of the scaffold as well as postoperative scaffold extrusion and the total remaining meniscal volume was also evaluated in MRI. RESULTS: Thirty-two patients were included. The mean follow-up was 70.8 ± 7.5 months. The functionality of the knees improved in all the scores used (P < .001) except for the Tegner score that stayed steady. Most of meniscal implants showed extrusion of 2.4 mm (95% confidence interval [CI], 1.1-3.7) were smaller and a hyperintensity signal was seen in the MRI. Three scaffolds were resorbed at the last follow-up. The meniscal volume, determined by MRI, was 1.14 cm3 (95% CI, 0.96-1.31) preoperatively and 1.61 cm3 (95% CI, 1.43-1.7) at the last follow-up. No differences were presented. CONCLUSIONS: The use of a polyurethane meniscal scaffold in patients with a symptomatic meniscus deficit had a good functional outcome at 5 years after surgery. However, the implanted scaffolds did not present normal meniscal tissue with MRI, and the implant volume was considerably less than expected. The fact that most of patients included received different concomitant procedures during scaffold implantation introduces a degree of performance bias into the results. LEVEL OF EVIDENCE: Level IV, case series.
Authors: Philipp W Winkler; Benjamin B Rothrauff; Rafael A Buerba; Neha Shah; Stefano Zaffagnini; Peter Alexander; Volker Musahl Journal: J Exp Orthop Date: 2020-07-25
Authors: Raquel Arredondo; Francesco Poggioli; Santos Martínez-Díaz; María Piera-Trilla; Raúl Torres-Claramunt; Laura Tío; Joan C Monllau Journal: Regen Ther Date: 2021-11-26 Impact factor: 3.419