title: Long-term outcomes of medial CMI implant versus partial medial meniscectomy in patients with concomitant ACL reconstruction.
abstract: OBJECTIVE
  To compare the clinical, objective and radiographic long-term results of patients with anterior cruciate ligament (ACL) lesion and partial medial meniscus defects, treated with ACL reconstruction and partial medial meniscectomy or medial CMI implant.
  
  
  METHODS
  Seventeen patients treated with combined ACL reconstruction and medial CMI and 17 patients treated with ACL reconstruction and partial medial meniscectomy were evaluated with mean follow-up 9.6 years with Lysholm, Tegner, objective and subjective International Knee Documentation Committee scores, and VAS for pain. Arthrometric evaluation was performed with KT 2000. Weigh-bearing radiographs, antero-posterior and Rosenberg view, were also performed and evaluated with Kellgren-Lawrence score, Ahlback score and joint space narrowing.
  
  
  RESULTS
  Pre-operative demographic parameters and clinical scores between patients treated with CMI and partial medial meniscectomy revealed no significant differences. A significant improvement of all the clinical scores was detected in both groups from pre-operative status to final follow-up. No significant difference between groups were found for clinical and radiographic scores; however, the chronic subgroup of patients treated with CMI showed a significantly lower level of post-operative knee pain compared to patients treated with partial medial meniscectomy and the acute subgroup of medial CMI showed better arthrometric scores.
  
  
  CONCLUSIONS
  Good long-term clinical results in terms of stability, subjective outcomes and objective evaluation were reported both for medial CMI implant and partial medial meniscectomy, combined with ACL reconstruction for the treatment of partial medial meniscus tears combined with ACL lesions. Chronic meniscal tears treated with medial CMI reported lower levels of post-operative pain compared to meniscectomy, while acute lesions treated with medial CMI showed less knee laxity. Therefore, the use of the collagen meniscus implant in the case of anterior knee instability with a meniscal defect appears justified and able to improve clinical outcomes in the long term.
  
  
  METHODS
  Retrospective comparative study, Level III.
authors.affiliation: Dipartimento di Biotecnologie e Scienze della Vita, Università degli Studi dell'Insubria, Varese, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Bulgheroni
authors.affiliation: Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Grassi
authors.affiliation: Dipartimento di Biotecnologie e Scienze della Vita, Università degli Studi dell'Insubria, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bulgheroni
authors.affiliation: Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.affiliation: Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Bologna, Italy. s.zaffagnini@biomec.ior.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.affiliation: Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D003094:Collagen / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D065466:Lysholm Knee Score; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D019736:Prostheses and Implants; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries; D054457:Tissue Scaffolds
chemical_list: D003094:Collagen
keywords: ACL; CMI; Meniscus; Osteoarthritis