2015 ISAKOS Biennial Congress ePoster #1609

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

Pablo E. Gelber, MD, PhD, Barcelona SPAIN
Àngel Masferrer-Pino, MD, Barcelona SPAIN
Teresa Marlet, MD, Barcelona SPAIN
Marina Besalduch, MD, Barcelona SPAIN
Raquel Marí-Molina, MD, Barcelona SPAIN
Joan C. Monllau, MD, PhD, Prof., Barcelona SPAIN

Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Barcelona, SPAIN

FDA Status Not Applicable

Summary: Patients without chondral injuries showed a better MRI aspect of a meniscal 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 was observed after a minimum two-year follow-up.

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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 clinical outcome and imaging aspect of a polyurethane meniscal scaffold (Actifit®).

Methods

54 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 8 with grade 4 chondral lesions. WOMET, IKDC and Kujala improved from 36.2±7.6, 32.3±13.5 and 39.2±8.1 to 75.8±12.9 (p=0.02), 75.5±15.4 (p=0.03) and 85.6±13.4 (0.042), respectively. There was no relationship between the severity of chondral injury and functional scores. The morphology and size of the implant in the MRI were worse with a higher degree of chondral injury (p=0.023).

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 was observed after a minimum two-year follow-up.