title: Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy: a minimum 10-year follow-up study.
abstract: BACKGROUND
  Loss of meniscal tissue can be responsible for increased pain and decreased function.
  
  
  OBJECTIVE
  At a minimum 10-year follow-up, patients receiving a medial collagen meniscus implant (MCMI) would show better clinical, radiological, and magnetic resonance imaging (MRI) outcomes than patients treated with partial medial meniscectomy (PMM).
  
  
  METHODS
  Cohort study; Level of evidence 2.
  
  
  METHODS
  Thirty-three nonconsecutive patients (men; mean age, 40 years) with meniscal injuries were enrolled in the study to receive MCMI or to serve as a control patient treated with PMM. The choice of treatment was decided by the patient. All patients were clinically evaluated at time 0 and at 5 years and a minimum of 10 years after surgery (mean follow-up, 133 months) by Lysholm, visual analog scale (VAS) for pain, objective International Knee Documentation Committee (IKDC) knee form, and Tegner activity level scores. The SF-36 score was performed preoperatively and at final follow-up. Bilateral weightbearing radiographs were completed before the index surgery and at final follow-up. Minimum 10-year follow-up MRI images were compared with preoperative MRI images by means of the Yulish score. The Genovese score was also used to evalute MCMI MRI survivorship.
  
  
  RESULTS
  The MCMI group, compared with the PMM one, showed significantly lower VAS for pain (1.2 ± 0.9 vs 3.3 ± 1.8; P = .004) and higher objective IKDC (7A and 10B for MCMI, 4B and 12C for PMM; P = .0001), Teger index (75 ± 27.5 vs 50 ± 11.67; P = .026), and SF-36 (53.9 ± 4.0 vs 44.1 ± 9.2; P = .026 for Physical Health Index; 54.7 ± 3.8 vs 43.8 ± 6.5; P = .004 for Mental Health Index) scores. Radiographic evaluation showed significantly less medial joint space narrowing in the MCMI group than in the PMM group (0.48 ± 0.63 mm vs 2.13 ± 0.79 mm; P = .0003). No significant differences between groups were reported regarding Lysholm (P = .062) and Yulish (P = .122) scores. Genovese score remained constant between 5 and 10 years after surgery (P = .5). The MRI evaluation of the MCMI patients revealed 11 cases of myxoid degeneration signal: 4 had a normal signal with reduced size, and 2 had no recognizable implant.
  
  
  CONCLUSIONS
  Pain, activity level, and radiological outcomes are significantly improved with use of the MCMI at a minimum 10-year follow-up compared with PMM alone. Randomized controlled trials on a larger population are necessary to confirm MCMI benefits at long term.
authors.affiliation: Sports Traumatology Department and Biomechanics Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy. s.zaffagnini@biomec.ior.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.forename: Nicola
authors.initials: N
authors.lastname: Lopomo
authors.forename: Danilo
authors.initials: D
authors.lastname: Bruni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giordano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ravazzolo
authors.forename: Massimo
authors.initials: M
authors.lastname: Molinari
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures; D011446:Prospective Studies; D019919:Prosthesis Implantation; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult