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Philipps-Universität Marburg
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Abstract
There is lack of information about midterm results of Actifit®-Scaffolds, which showed pain reduction and improvement of knee function in earlier studies. The purpose of this study was to evaluate the clinical and radiology results six years after implantation of a polyurethane scaffold.
Eighteen patients were operated arthroscopically and an Actifit® polyurethane meniscal implant (Orteq Sports Medicine, London, UK) was integrated into the meniscal tissue. All patients suffered from a postmeniscal-syndrom. Follow-up occurred at six months, a year, as well as after two, four and six years. The clinical outcomes were assessed using valid classifications for pain, symptoms, knee function and activity (VAS, KOOS, KSS, UCLA Activity Scale). In order to evaluate scaffold morphology, tissue integration, status of the articular cartilage, and signs of inflammation, an MRI scan was performed after six months, a year, two, four and six years.
Four patients were lost during the follow-up. One patient dropt out.
Median patient age was 36.9 (range 24–52 years). After six years a significant reduction of pain in the VAS- Score and an improvement of The KSS Knee and Function Scores compared to the knee function prior to the Actifit®-Scaffold implantation could be measured (mean VAS and KSS :5 vs.1 p=0,001 ; 65,2 vs. 82,9 p=0,001; 66 vs. 95 p=0,001 ). According to UCLA the activity level continued to improve after six years up to competitive sport (5,4 vs. 7,6 p= 0,007 )
The KOOS showed significant improvement in pain reduction, the knee function in daily life, sports and quality of life compared with preoperative figures (7 vs. 92 p= 0,001; 52,8 vs. 91 p=0,001; 26,2 vs. 79,8 p=0,001; 28,1 vs. 74 p=0,001). Only the subclass symptoms showed no significant change (60 vs. 86,7 p=0,562). We have to report a treatment failure (7,6% n=13) after one patient received an high tibial osteotomy between the four and six year follow up.
ICRS cartilage score was constant over six years. The MRI showed the meniscal scaffold with a hyperintens signal and reduced size and four fully resorbed scaffolds. Four extrusions, four bone bruises and three synovitides where documented. One bone bruise correlated with a significant worsening of the clinical Outcome in KOOS (KOSS: 93 vs.57; p=0,04) compared to the follow-up after four years. The patient participated in competitive sport, thus patient should be informed about possible consequences.
In conclusion, it has been shown that the Actifit®-Scaffold contributes to pain reduction and obtains knee function. The cartilage status remains constant.
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Dates
Created: 2020Issued: 2021-01-21Updated: 2021-01-21
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
meniscal leasionMeniskusimplantat aus Polyurethanpostmeniscal-syndromMeniskusläsionMeniskusverletztungMeniskusmeniscuspolyurethane meniscal implantActifit-ScaffoldsGonarthrosePostmeniskeketomie Syndrom
DFG-subjects
ActifitMeniskusimplantat
DDC-Numbers
610
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Pollkläsener, Linda: Mittelfristige Ergebnisse eine zellfreien Implantates aus Polyurethan. : Philipps-Universität Marburg 2021-01-21. DOI: https://doi.org/10.17192/z2021.0017.