title: Partial meniscus substitution with a polyurethane scaffold does not improve outcome after an open-wedge high tibial osteotomy.
abstract: OBJECTIVE
  The aim of the study was to determine whether medial meniscal substitution with a polyurethane scaffold (Actifit(®)) improves the outcome of medial meniscal-deficient varus knees undergoing open-wedge high tibial osteotomy.
  
  
  METHODS
  Sixty patients with symptomatic varus knees those who underwent open-wedge high tibial osteotomies were prospectively studied. In 30 patients, the medial meniscus was left with a defect larger than 25 mm (Group M). An Actifit(®) device was implanted (Group A) in the remaining 30 patients. Patients were functionally evaluated with WOMET, IKDC and VAS. Patient satisfaction was graded from 0 (not satisfied) to 4 (very satisfied).
  
  
  RESULTS
  Both groups were comparable preoperatively. They had similar follow-up periods (31.2 months; range 24-47.5; n.s.). WOMET improved a mean of 53.4 ± 8.4 and 42.4 ± 17.2 points in Groups M and A, respectively (p = 0.002). IKDC improved a mean of 56.7 ± 12 and 50.3 ± 15.6 points in Groups M and A, respectively (n.s.). VAS dropped 5.9 ± 2.1 and 4.7 ± 2.8 points in Groups M and A, respectively (p = 0.006). Patient satisfaction averaged 3.3 ± 0.8 and 3.3 ± 1 in Groups M and A, respectively (n.s.).
  
  
  CONCLUSIONS
  Patients with symptomatic varus knees were treated with open-wedge high tibial osteotomies, and a meniscectomy was improved more at short-term follow-up in most of the evaluated functional scores than those patients with concomitant implantation of a medial Actifit(®) implant. However, there was no difference in terms of patient satisfaction with the procedure. Based on the short-term functional results of this study, no data were provided to support medial meniscal substitution with a polyurethane scaffold when an open-wedge high tibial osteotomy is being performed.
  
  
  METHODS
  Prospective comparative study, Level II.
authors: ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, c/Sabino de Arana 5-19, 08028, Barcelona, Spain, pablogelber@gmail.com.
authors: Pablo Eduardo
authors: PE
authors: Gelber
authors: Anna
authors: A
authors: Isart
authors: Juan Ignacio
authors: JI
authors: Erquicia
authors: Xavier
authors: X
authors: Pelfort
authors: Marc
authors: M
authors: Tey-Pons
authors: Juan Carlos
authors: JC
authors: Monllau
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D017060:Patient Satisfaction; D011140:Polyurethanes; D011446:Prospective Studies; D019736:Prostheses and Implants; D013977:Tibia / Q000601:surgery*; D000070600:Tibial Meniscus Injuries; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011140:Polyurethanes