Functional and magnetic resonance imaging outcome after polyurethane meniscal scaffold implantation following partial me
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ORIGINAL PAPER
Functional and magnetic resonance imaging outcome after polyurethane meniscal scaffold implantation following partial meniscectomy Miroslav Haspl 1
&
Denis Trsek 1 & Drazen Lovric 1 & Borna Strahonja 1 & Damir Matokovic 2,3
Received: 2 September 2020 / Accepted: 30 September 2020 # SICOT aisbl 2020
Abstract Purpose Prevention of the knee osteoarthritis following meniscectomy is implantation of an allotransplant or an artificial meniscus. We present retrospective study of our early results of the treatment using polyurethane meniscal scaffold. Methods From 2016 to 2020, we implanted nine polyurethane scaffolds (Actifit) after partial meniscectomy, five males and four females, age 36 (16–47), BMI 26.7 (17.2–35.9) kg/m2. Functional status, activity, pain, and MRI were assessed. Results FU 20.8 (6–48.5) months, 35.2 (0–68) months from the meniscectomy to the implantation. The average implant length was 46.1 (35–60) mm, average number of sutures was 7.6 (5–10). Lysholm score before surgery was 61.7 (49–85), after the surgery 86.4 (62–95) with p 0.0045, Tegner activity score before meniscectomy was 5.8 (4–7), after 3.8 (2–5), and after the scaffold implantation 4.6 (3–7) with p 0.0488. Before surgery, VAS score was 3.1 (2–4), and after 7.7 (5–9) with p 0.0042. Pursuant to the Genovese classification, the last follow-up MRI showed a type 2 meniscal morphology in four cases and a type 3 in five cases. Seven patients had type 1 and two had type 2 signal intensity. On average, the absolute extrusion of a transplanted meniscus was 3.67 mm, and the relative extrusion was 0.58 mm. Extrusion progress was not detected. Conclusion Significantly improved knee functionality, increased level of physical activity, and reduced pain. MRI analysis revealed the meniscal transplant morphology and volume loss, as well as its extrusion without progression. Keywords Knee . Meniscectomy . Transplantation . Meniscal scaffold
Introduction Meniscectomy is the most common surgical procedure of the knee joint. The role of the meniscus is well known and well studied. Following a meniscectomy, and depending on the size of the missing part of the meniscus, a secondary osteoarthritis of the knee develops. The larger the part removed, the greater the stress on the cartilage, and degenerative changes occur earlier and progress faster. Painful conditions after meniscectomy are common as well [1]. * Miroslav Haspl [email protected] 1
AKROMION, Special Hospital for Orthopaedic Surgery, Ljudevita Gaja 2, 49217 Krapinske Toplice, Croatia
2
County General Hospital Pozega, Osjecka 107, 34000 Pozega, Croatia
3
Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
This is why it is recommended to suture a ruptured meniscus and to preserve it whenever feasible [2]. Following a meniscectomy, especially in the case of pain in the area of meniscal resection, meniscal transplantation is indicated. There are two options for consideration: the implantation of a meniscal allograft and the implantation of an artificial menisc
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