Improvement in outcomes after implantation of a novel polyurethane meniscal scaffold for the treatment of medial meniscus deficiency

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• 作者：Karl F. Schüttler ; Steffen P?ttgen…
• 关键词：Actifit ; Meniscus ; Biodegradable scaffold ; MRI ; Polyurethane scaffold ; Partial meniscectomy ; Irreparable meniscal defect
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：23
• 期：7
• 页码：1929-1935
• 全文大小：768 KB
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• 作者单位：Karl F. Schüttler (1)
  Steffen P?ttgen (1)
  Alan Getgood (2)
  Marga B. Rominger (3)
  Susanne Fuchs-Winkelmann (1)
  Philip P. Roessler (1)
  Ewgeni Ziring (4)
  Turgay Efe (1)
  
  1. Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
  2. Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON, Canada
  3. Department of Radiology, University Hospital Marburg, Marburg, Germany
  4. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Marburg, Marburg, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-7347

文摘

Purpose 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 17-9) 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. Conclusion 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. Level of evidence IV.