title: Midterm follow-up after implantation of a polyurethane meniscal scaffold for segmental medial meniscus loss: maintenance of good clinical and MRI outcome.
abstract: OBJECTIVE
  The preservation of meniscal structure and function after segmental meniscal loss is of crucial importance to prevent early development of osteoarthritis. Implantation of artificial meniscal implants has been reported as a feasible treatment option. The purpose of this study was to assess the clinical and magnetic resonance imaging (MRI) results 4 years after implantation of a polyurethane scaffold for chronic segmental medial meniscus deficiency following partial medial meniscectomy.
  
  
  METHODS
  Eighteen patients received arthroscopic implantation of an Actifit(®) polyurethane meniscal implant (Orteq Sports Medicine, London, UK) for deficiency of the medial meniscus. Patients were followed at 6, 12, 24, and 48 months. Clinical outcome was assessed using established patient-reported outcome scores (KOOS, KSS, UCLA Activity Scale, VAS for pain). Radiological outcome was quantified by MRI scans after 6, 12, 24, and 48 months evaluating scaffold morphology, tissue integration, and status of the articular cartilage as well as signs of inflammation.
  
  
  RESULTS
  Median patient age was 32.5 years (range 17-49 years) with a median meniscal defect size of 44.5 mm (range 35-62 mm). Continuing improvement of the VAS and KSS Knee and Function Scores could be observed after 48 months compared to baseline, whereas improvement of the activity level according to UCLA continued only up to 24 months and decreased from there on. The KOOS Score showed significant improvement in all dimensions. MRI scans showed reappearance of bone bruises in two patients with scaffold extrusion. No significant changes in the articular cartilage could be perceived.
  
  
  CONCLUSIONS
  Arthroscopic treatment for patients with chronic segmental meniscal loss using a polyurethane meniscal implant can achieve sustainable midterm results regarding pain reduction and knee function.
  
  
  METHODS
  IV.
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
authors: Karl F
authors: KF
authors: Schüttler
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
authors: Felix
authors: F
authors: Haberhauer
authors: Department of Trauma and Orthopedic Surgery, Paracelcus Medical University, Nuremberg, Germany.
authors: Markus
authors: M
authors: Gesslein
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
authors: Thomas J
authors: TJ
authors: Heyse
authors: Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Marburg, Germany.
authors: Jens
authors: J
authors: Figiel
authors: Department of Orthopedic Surgery, Saarland University, Homburg, Saar, Germany.
authors: Olaf
authors: O
authors: Lorbach
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany. efet@med.uni-marburg.de.
authors: Turgay
authors: T
authors: Efe
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.|Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
authors: Philip P
authors: PP
authors: Roessler
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001672:Biocompatible Materials; D002357:Cartilage Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011140:Polyurethanes; D019919:Prosthesis Implantation; D000070600:Tibial Meniscus Injuries / Q000601:surgery*; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D011140:Polyurethanes
keywords: Actifit; Biodegradable scaffold; Irreparable meniscal defect; MRI; Meniscus; Partial meniscectomy; Polyurethane scaffold