title: Meniscal scaffolds: early experience and review of the literature.
abstract: BACKGROUND
  Meniscal scaffold implants support the in-growth of new "meniscus like" tissue with the aim of alleviating post-meniscectomy knee pain and preventing further articular cartilage degeneration.
  
  
  METHODS
  Twenty-three patients underwent meniscal scaffold implantation (14 medial, 9 lateral) with either the Menaflex (ReGen Biologics) (n=12) or Actifit (Orteq) (n=11) scaffolds. Minimum follow-up was 1 year with a mean of 24.1 months (18-27) for the Menaflex and 14.7 months (12-18) for the Actifit groups. Mean age at surgery was 35 years (17-47) with a mean Outerbridge grade of 1.9 in the affected compartment. Eight (36%) underwent concurrent osteotomy, ligament reconstruction or microfracture of the tibial plateau. KOOS, Lysholm, Tegner activity and IKDC scores were collected pre-operatively and at six-month interval post-surgery. Assessment of the reconstruction was obtained with MRI scanning and arthroscopy. One scaffold tore and was revised at 19 months post-operatively.
  
  
  RESULTS
  Twenty-one out of 23 (91.3%) had a significant improvement in knee scores when compared to pre-surgery levels at latest follow-up. Second-look arthroscopy in 14 at 1-year post-implantation showed variable amounts of regenerative tissue. There was no progression in chondral wear noted on repeat MRI scanning.
  
  
  CONCLUSIONS
  Treatment with meniscal scaffold implants can provide good pain relief for the post-meniscectomy knee following partial meniscectomy. Longer follow-up is required to ascertain whether they also prevent the progressive chondral wear associated with a post-meniscectomy knee.
authors.affiliation: University Hospital Coventry and Warwickshire NHS Trust, UK. simon.spencer@nhs.net
authors.forename: S J
authors.initials: SJ
authors.lastname: Spencer
authors.forename: A
authors.initials: A
authors.lastname: Saithna
authors.forename: M R
authors.initials: MR
authors.lastname: Carmont
authors.forename: M S
authors.initials: MS
authors.lastname: Dhillon
authors.forename: P
authors.initials: P
authors.lastname: Thompson
authors.forename: T
authors.initials: T
authors.lastname: Spalding
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D048091:Guided Tissue Regeneration / Q000295:instrumentation*; D006801:Humans; D007719:Knee Joint; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D055815:Young Adult