Meniscal scaffold for the treatment of partial meniscal defect-clinical and radiological outcomes in a two-year follow-up

Int Orthop. 2021 Apr;45(4):977-983. doi: 10.1007/s00264-020-04811-7. Epub 2020 Sep 19.

Abstract

Purpose: The aim of meniscal scaffolds is to fill the defect, allow regeneration of meniscal-like tissues, and to prevent long-term risk of cartilage wear and tear. The aim of this study was to evaluate clinical results after two years and magnetic resonance imaging (MRI) results a year after implantation of a meniscal scaffold.

Methods: Fifteen patients were recruited into a prospective, single-arm, single-center study, and treated with meniscal scaffolds as a result of segmental meniscal defect due to previous partial meniscectomy. Patients were evaluated using functional knee scores used pre-operatively and 6, 12, and 24 months postoperatively. The radiological outcome was assessed using MRI at 12 months by evaluating scaffold size, morphology, and intensity according to the Genovese grading system. Cartilage assessment was completed according to The International Cartilage Repair Society (ICRS) score.

Results: All patients completed a follow-up of 24 months. A statistically significant increase in mean levels of all functional scores was present in all patients. On the MRI, all but one of the patients presented an incorporated meniscal implant. In most of the patients (73%), the meniscal implant was a Genovese type III. Type II and III signal intensities were present in all scaffolds when compared with the residual meniscal tissue. A stable cartilage (ICRS) status was observed in 80% of the patients compared with the pre-operative cartilage scores.

Conclusion: In our case series of patients treated with the meniscal scaffold implant, we observed good clinical results at a two year follow-up. Furthermore, MRI findings suggest that meniscal scaffolds might have a beneficial effect on articular cartilage.

Keywords: Irreparable meniscal defect; Knee; MRI; Meniscus; Scaffold.

MeSH terms

  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Menisci, Tibial / diagnostic imaging
  • Menisci, Tibial / surgery
  • Polyurethanes
  • Prospective Studies
  • Tibial Meniscus Injuries* / diagnostic imaging
  • Tibial Meniscus Injuries* / surgery
  • Tissue Scaffolds
  • Treatment Outcome

Substances

  • Polyurethanes