Objectives: The possibility to reproduce the meniscus structure and function is highly attractive, aiming to restore knee biomechanics and to prevent the development of early osteoarthritis. Regenerative approaches have been advocated to improve the reparative processes of joint tissues, and good results have already been reported in the literature at long-term1. Recently, a new polyurethane scaffold (Actifit™,Orteq Ltd, UK) has been introduced in clinical practice claiming better material properties to resist the high knee forces and therefore a better chondroprotection2. Methods: We performed a prospective clinical evaluation of 18 patients (11 males, 7 females, mean age 45 y) affected by a massive loss of meniscal substance either medial or lateral (13 and 5, respectively), associated with intra-articular or global knee pain and/or swelling, and treated with Actifit™ implantation. Nine patients also underwent associated procedures involving cartilage treatment or osteotomies. Patients were evaluated clinically and with MRI up to 2 years of follow-up. Results: The evaluation of the patients who underwent Actifit™ implantation showed good results at short term follow-up, both from the clinical and imaging point of view. One patient had a reinjury playing competitive soccer after the 12 months evaluation and was excluded from the subsequent analysis. IKDC subjective score improved from 47,3±17,5 to 72,9±13,9 (p< 0,0005) at 1 year and 74,6±15,3 (p< 0,0005) at 2 years of follow-up, but an even higher improvement (77,7±15,7, p< 0,0005) was documented when analyzing patients without associated treatment of chondral lesions or osteotomy. Conclusions: Our results documented a significant clinical improvement treating partial meniscal lesions with scaffold implantation. Short term results after Actifit™ implantation are promising and similar to first generation scaffold, but long term randomized studies are needed to confirm if the better structural properties will lead also to better long-term clinical outcome and joint protection
S. Zaffagnini, E. Kon, G.M. Marcheggiani Muccioli, G. Filiardo, M. Busacca, M. Marcacci (2012). Meniscal re generation by a new polyurethane scaffold. A 2-year minimum follow-up study.. s.l : s.n.
Meniscal re generation by a new polyurethane scaffold. A 2-year minimum follow-up study.
ZAFFAGNINI, STEFANO;KON, ELIZAVETA;MARCHEGGIANI MUCCIOLI, GIULIO MARIA;FILARDO, GIUSEPPE;MARCACCI, MAURILIO
2012
Abstract
Objectives: The possibility to reproduce the meniscus structure and function is highly attractive, aiming to restore knee biomechanics and to prevent the development of early osteoarthritis. Regenerative approaches have been advocated to improve the reparative processes of joint tissues, and good results have already been reported in the literature at long-term1. Recently, a new polyurethane scaffold (Actifit™,Orteq Ltd, UK) has been introduced in clinical practice claiming better material properties to resist the high knee forces and therefore a better chondroprotection2. Methods: We performed a prospective clinical evaluation of 18 patients (11 males, 7 females, mean age 45 y) affected by a massive loss of meniscal substance either medial or lateral (13 and 5, respectively), associated with intra-articular or global knee pain and/or swelling, and treated with Actifit™ implantation. Nine patients also underwent associated procedures involving cartilage treatment or osteotomies. Patients were evaluated clinically and with MRI up to 2 years of follow-up. Results: The evaluation of the patients who underwent Actifit™ implantation showed good results at short term follow-up, both from the clinical and imaging point of view. One patient had a reinjury playing competitive soccer after the 12 months evaluation and was excluded from the subsequent analysis. IKDC subjective score improved from 47,3±17,5 to 72,9±13,9 (p< 0,0005) at 1 year and 74,6±15,3 (p< 0,0005) at 2 years of follow-up, but an even higher improvement (77,7±15,7, p< 0,0005) was documented when analyzing patients without associated treatment of chondral lesions or osteotomy. Conclusions: Our results documented a significant clinical improvement treating partial meniscal lesions with scaffold implantation. Short term results after Actifit™ implantation are promising and similar to first generation scaffold, but long term randomized studies are needed to confirm if the better structural properties will lead also to better long-term clinical outcome and joint protectionI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
