Title: Integration of polyurethane meniscus scaffold during ACL revision is not reliable at 5 years despite favourable clinical outcome

Journal Article · · Knee Surgery, Sports Traumatology, Arthroscopy
ORCiD logo [1];  [2];  [2];  [2];  [3];  [3];  [4];  [5];  [2];  [6]
  1. 3B’s Research Group; I3Bs‐Research Institute on Biomaterials; Biodegradables and Biomimetics University of Minho Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark; Parque de Ciência e Tecnologia; Zona Industrial da Gandra; Barco 4805‐017 Guimarães Portugal; ICVS/3B’s‐PT Government Associate Laboratory Braga/Guimarães Portugal; Orthopedic Department Centro Hospitalar Póvoa de Varzim Vila do Conde Portugal; Ripoll y de Prado Sports Clinic‐FIFA Medical Centre of Excellence Murcia‐Madrid Spain
  2. 3B’s Research Group, I3Bs‐Research Institute on Biomaterials, Biodegradables and Biomimetics University of Minho Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco 4805‐017 Guimarães Portugal, ICVS/3B’s‐PT Government Associate Laboratory Braga/Guimarães Portugal
  3. Clínica Espregueira‐FIFA Medical Centre of Excellence Porto Portugal
  4. Ripoll y de Prado Sports Clinic‐FIFA Medical Centre of Excellence Murcia‐Madrid Spain
  5. Sahlgrenska Sports Medicine Center Gothenburg Sweden, Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden, Department of Orthopaedics Sahlgrenska University Hospital Mölndal Sweden
  6. 3B’s Research Group; I3Bs‐Research Institute on Biomaterials; Biodegradables and Biomimetics University of Minho Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark; Parque de Ciência e Tecnologia; Zona Industrial da Gandra; Barco 4805‐017 Guimarães Portugal; ICVS/3B’s‐PT Government Associate Laboratory Braga/Guimarães Portugal; Clínica Espregueira‐FIFA Medical Centre of Excellence Porto Portugal
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Abstract Purpose The aim of this study was to evaluate the clinical outcome at 5‐year follow‐up of a one‐step procedure combining anterior cruciate ligament (ACL) reconstruction and partial meniscus replacement using a polyurethane scaffold for the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy. Moreover, the implanted scaffolds have been evaluated by MRI protocol in terms of morphology, volume, and signal intensity. Methods Twenty patients with symptomatic knee laxity after failed ACL reconstruction and partial medial meniscectomy underwent ACL revision combined with polyurethane‐based meniscal scaffold implant. Clinical assessment at 2‐ and 5‐year follow‐ups included VAS, Tegner Activity Score, International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lysholm Score. MRI evaluation of the scaffold was performed according to the Genovese scale with quantification of the scaffold’s volume at 1‐ and 5‐year follow‐ups. Results All scores revealed clinical improvement as compared with the preoperative values at the 2‐ and 5‐year follow‐ups. However, a slight, but significant reduction of scores was observed between 2 and 5 years. Concerning the MRI assessment, a significant reduction of the scaffold’s volume was observed between 1 and 5 years. Genovese Morphology classification at 5 years included two complete resorptions (Type 3) and all the remaining patients had irregular morphology (Type 2). With regard to the Genovese Signal at the 5‐year follow‐up, three were classified as markedly hyperintense (Type 1), 15 as slightly hyperintense (Type 2), and two as isointense (Type 1). Conclusion Simultaneous ACL reconstruction and partial meniscus replacement using a polyurethane scaffold provides favourable clinical outcomes in the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy at 5 years. However, MRI evaluation suggests that integration of the scaffold is not consistent. Level of evidence Level IV.

Sponsoring Organization:
USDOE
OSTI ID:
2566624
Journal Information:
Knee Surgery, Sports Traumatology, Arthroscopy, Journal Name: Knee Surgery, Sports Traumatology, Arthroscopy Journal Issue: 10 Vol. 30; ISSN 0942-2056
Publisher:
Wiley Blackwell (John Wiley & Sons)Copyright Statement
Country of Publication:
Country unknown/Code not available
Language:
English

References (14)

Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS‐PS), Knee Outcome Survey Activities of Daily Living Scale (KOS‐ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS) journal November 2011
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Actifit ® polyurethane meniscal scaffold: MRI and functional outcomes after a minimum follow-up of 5 years journal June 2017
Reliability of an Automated Computerized Hematoma Volumetric Analysis Protocol in Patients with Chronic Subdural Hemorrhage journal June 2021
Comment on Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-Up journal November 2020
Revision Anterior Cruciate Ligament Reconstruction journal June 2008
A Comprehensive Review of Partial Anterior Cruciate Ligament Tears journal January 2009
A Rare Complication after Synthetic Meniscus Replacement journal October 2018
Meniscal Transplants and Scaffolds: A Systematic Review of the Literature journal March 2017

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