Literature DB >> 33717911

Meniscal polyurethane scaffold plus cartilage repair in post meniscectomy syndrome patients without malalignment improves clinical outcomes at mid-term follow-up.

David Figueroa1, Francisco Figueroa1,2, Rafael Calvo1, Carlos Gomez3,4, Alex Vaisman1,3.   

Abstract

BACKGROUND: The aim of this study is to report the mid-term follow-up results of a prospective cohort of patients who underwent a polyurethane (PU) meniscal scaffold implantation for post meniscectomy syndrome (PMS), without limb realignment procedures.
METHODS: Prospective study in patients with PU meniscal scaffolds implanted during 2014-2016. Limb realignment procedures excluded. Clinical outcomes were prospectively evaluated pre-operatively and every year post-operatively using patient-reported outcome scores (KOOS, VAS, Lysholm and IKDC). Post-operative radiologic evaluation was done using 3.0 T magnetic resonance imaging (MRI). Meniscal scaffold extrusion, signal intensity, tibio-femoral cartilage degeneration progression and complications were analyzed.
RESULTS: Fourteen patients with an average age of 25.8 years (range: 17-47) received a PU scaffold (8 lateral and 6 medial). Associated procedures were done in all patients, with an osteochondral allograft transplantation (OAT) being the most common. Mean follow up was 51.6 (range: 39-66) months. Post-operative mean clinical outcomes scores showed significantly improved results compared to the pre-operative scores. Lysholm scores increased from 62.4 to 80.2 (P = 0.0023), KOOS from 68.9 to 80 (P = 0.0083) and VAS for pain decreased from 5.3 to 3.1 (P = 0.0024). Average post-operative IKDC score was 67.7. There were 8 cases of complete extrusion (>3 mm). The mean extrusion value was 4.0 mm (range: 3-6 mm). Three patients showed signs of a ruptured meniscal scaffold. One patient showed progression of the cartilage degenerative process.
CONCLUSION: The use of a PU scaffold, associated with other surgical procedures in the knee, especially chondral repair, had a significant improvement in clinical outcomes compared to the baseline status, at an average of 51.6 months follow-up in patients suffering from PMS. Although imaging results show a high proportion of implant extrusion, this does not appear to imply a worsening in clinical outcomes in the short term. LEVEL OF EVIDENCE: IV. Case series.
© 2020 Delhi Orthopedic Association. All rights reserved.

Entities:  

Keywords:  Actifit; Implant; Meniscal; Polyurethane; Scaffold

Year:  2020        PMID: 33717911      PMCID: PMC7920011          DOI: 10.1016/j.jcot.2020.11.006

Source DB:  PubMed          Journal:  J Clin Orthop Trauma        ISSN: 0976-5662


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