Improvement in outcomes after implantation of a novel polyurethane meniscal scaffold for the treatment of medial meniscus deficiency.
OBJECTIVE
Meniscal injury resulting in segmental loss of meniscal tissue is a major risk factor for the development of osteoarthritis. Tissue engineering strategies have provided scaffolds for meniscal regeneration in order to establish a treatment option for patients with limited opportunities for meniscal reconstruction. The purpose of this study was to assess the clinical and magnetic resonance imaging (MRI) results 2 years after implantation of a polyurethane scaffold for chronic segmental medial meniscus deficiency following partial medial meniscectomy.


METHODS
Eighteen patients were treated with arthroscopic implantation of an ActiFit(®) (Orteq Sports Medicine) polyurethane meniscal scaffold for meniscus deficiency of the medial meniscus. Patients were followed up at 6, 12, and 24 months. Clinical outcome was assessed using patient-reported outcome scores (KOOS, KSS, UCLA activity scale, VAS for pain). Radiological outcome was assessed using MRI at 6, 12, and 24 months by evaluating scaffold morphology, scaffold integration, and additional joint injury, as well as joint inflammation.


RESULTS
Eighteen patients with a median age of 32.5 years (range 17-49) were enrolled. Statistically significant improvements were present in all patients, but one at 2 years compared to baseline in all categories. Complete resorption of the scaffold occurred in one patient representing a failure to treatment. MRI showed abnormal signal intensity of the scaffold when compared to residual meniscal tissue but without synovitis or joint inflammation. Extrusion of the scaffold was present in four patients. No correlation between scaffold extrusion and clinical outcome was observed.


CONCLUSIONS
Arthroscopic implantation of a polyurethane meniscal scaffold in patients with chronic segmental medial meniscus deficiency is not only a safe procedure but leads to good clinical results at a 2-year follow-up. Scaffold extrusion did not appear to affect clinical outcome.


METHODS
IV.
Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
Karl F
KF
Schüttler
Steffen
S
Pöttgen
Alan
A
Getgood
Marga B
MB
Rominger
Susanne
S
Fuchs-Winkelmann
Philip P
PP
Roessler
Ewgeni
E
Ziring
Turgay
T
Efe
D000293:Adolescent; D000328:Adult; D019643:Arthroplasty, Replacement; D001182:Arthroscopy; D006801:Humans; D007595:Joint Prosthesis; D007719:Knee Joint / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011140:Polyurethanes; D000070600:Tibial Meniscus Injuries; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D055815:Young Adult
D011140:Polyurethanes