Polyurethane scaffold for the treatment of partial meniscal tears. Clinical results with a minimum two-year follow-up

Abstract

Purpose: to evaluate the safety and effectiveness of the polyurethane meniscal scaffold through clinical examination, MRI and arthroscopic second look, over a minimum two-year follow-up.

Methods: between 2009 and 2011, 19 patients underwent meniscal scaffold implantation in our department (medial meniscus in 16 cases lateral meniscus in two cases, and bilateral in one case). All the patients were clinically evaluated preoperatively, and at 6, 12, and 24 months after surgery using Lysholm score, Tegner score, and VAS. Ten patients were studied with MRI, and nine patients were evaluated arthroscopically.

Results: no adverse reactions to the implant were observed. The clinical scores showed a significant improvement at 6 months and increased progressively over time. On MRI studies, the implants showed a clear hyperintense signal, sometimes irregular, and the chondral surface was preserved in all cases. At arthroscopic second look in the first months after surgery, the scaffold size was unchanged and the scaffold appeared light yellowish in color and well integrated into the surrounding tissues. At arthroscopic second look at 12 and 24 months the scaffold was found to have an irregular morphology and to be slightly reduced in size.

Conclusions: polyurethane meniscal scaffold is a good alternative to a collagen scaffold, but a longer follow-up is needed to evaluate the scaffold degradation and chondral coverage.

Level of Evidence: level IV, therapeutic case series.

Key Words

meniscus - polyurethane - replacement - scaffold - tear