2015 ISAKOS Biennial Congress ePoster #1636

A Polyurethane Meniscal Scaffold is Systematically Extruded Postoperatively Despite the Degree of the Preoperative Position of the Meniscal Rim

Pablo E. Gelber, MD, PhD, Barcelona SPAIN
Teresa Marlet, MD, Barcelona SPAIN
Marina Besalduch, MD, Barcelona SPAIN
Raquel Marí-Molina, MD, Barcelona SPAIN
Ferran Abat, MD, PhD, Barcelona, BARCELONA SPAIN
Juan I. Erquicia, MD, Barcelona SPAIN
Xavier Pelfort, PhD, Igualada 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 Cleared

Summary: Meniscal substitution with a polyurethane scaffold provided significant pain relieve and functional improvement after a minimum of 2 years’ follow-up. No relationship was observed in terms of extrusion between the preoperative meniscal rim and the postoperative outer border of the Actifit®. Similarly, no relationship between degree of Actifit® extrusion and functional scores were observed

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Abstract:

Purpose

To evaluate whether the degree of extrusion of the meniscal remnant determines the degree of extrusion of an implanted meniscal polyurethane scaffold (Actifit®) and to determine if this correlates with the clinical outcomes.

Methods

Ninety-four patients with symptomatic knee due to a postmeniscetomy syndrome in whom an Actifit® device was implanted were retrospectively studied. Magnetic resonance images (MRI) were performed pre and postoperatively. While extrusion of the meniscal remnant was measured before surgery, extrusion of the implant was assessed at the 2-years follow-up. Extrusion was calculated in the coronal MRI in mm and in percentage of the tissue size extruded. Patients were functionally evaluated with WOMET, IKDC, Kujala, Tegner and VAS scores.
The relationship between degree of preoperative and postoperative extrusion was analized with the T-Test paired.

Results

There were 66 males and 28 females with a median follow-up of 45 months (range 25-69). The patients had a median age of 41.3 years (range, 17-58 years). Previous meniscal remnant extrusion averaged 2.8mm ± 1.3 (34.1% ± 22.1) and the postoperative Actifit® implants had a mean extrusion of 3.0mm ± 1.4 (31.4 % ± 20.5; p<0.001). WOMET improved a mean of 67.6±20 points (p<0.001). IKDC improved a mean of 70.4±16.1 points (p<0.001). Kujala improved a mean of 83.3 ± 16.9 points (p<0.001) and Tegner 4±1.8 points (p<0.001). VAS dropped 2.7±2.1 points (p<0.001). There was no relationship between the extrusion before and after surgery (p=0.15). Similarly, no relationship between degree of Actifit® extrusion and functional scores were observed (p=0.78).

Conclusions

Meniscal substitution with a polyurethane scaffold provided significant pain relieve and functional improvement after a minimum of 2 years’ follow-up. No relationship was observed in terms of extrusion between the preoperative meniscal rim and the postoperative outer border of the Actifit®. Similarly, no relationship between degree of Actifit® extrusion and functional scores were observed