title: The magnetic resonance aspect of a polyurethane meniscal scaffold is worse in advanced cartilage defects without deterioration of clinical outcomes after a minimum two-year follow-up.
abstract: BACKGROUND
  Meniscal scaffolding is thought to provide functional improvement and to prevent cartilage degeneration. Advanced chondral injuries might damage the scaffold structural properties.
  
  
  OBJECTIVE
  To evaluate the influence of different degrees of articular chondral injuries on the imaging aspect of a polyurethane meniscal scaffold (Actifit®).
  
  
  METHODS
  Fifty-four patients operated on with an Actifit® were studied. The status of the articular cartilage in the involved compartment was classified according to ICRS. The characteristics of the implant were evaluated in MRI with the Genovese score. Functional scores included WOMET, IKDC and Kujala scores. The Genovese score was correlated with the degree of chondral injury and functional results.
  
  
  RESULTS
  The mean follow-up was 39 months (range 25-63). Additional procedures were performed in 69.5%. There were 19 patients without chondral injuries and 14 with grade 1, 10 with grade 3 and eight with grade 4 chondral lesions. The morphology and size of the implant on MRI scanning were worse with a higher degree of chondral injury (p=0.023). WOMET, IKDC and Kujala improved from 36.2SD ±7.6, 32.3SD ±13.5 and 39.2SD ±8.1 to 75.8SD ±12.9 (p=0.02), 75.5SD ±15.4 (p=0.03) and 85.6SD ±13.4 (0.042), respectively. There was no relationship between the severity of chondral injury and functional scores.
  
  
  CONCLUSIONS
  Patients without chondral injuries showed a better MRI aspect of the polyurethane scaffold in terms of size and morphology. By optimizing biomechanics, in particular the implantation of a meniscal substitute, significant pain relief and functional improvement were observed after a minimum two-year follow-up.
  
  
  METHODS
  Therapeutic case series; level 4.
authors.affiliation: Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain; ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain. Electronic address: pablogelber@gmail.com.
authors.forename: Pablo Eduardo
authors.initials: PE
authors.lastname: Gelber
authors.affiliation: Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain.
authors.forename: Alexandru Mihai
authors.initials: AM
authors.lastname: Petrica
authors.affiliation: ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Isart
authors.affiliation: Department of Orthopedic Surgery, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Mari-Molina
authors.affiliation: ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain; Department of Orthopedic Surgery, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Monllau
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D048091:Guided Tissue Regeneration; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011140:Polyurethanes; D000070600:Tibial Meniscus Injuries; D054457:Tissue Scaffolds
chemical_list: D011140:Polyurethanes
keywords: Actifit; Knee; Meniscal substitution; Meniscus; Scaffold