Summary

Differently from the 10 years follow-up, the clinical and the radiological outcomes of the medial CMI were not superior compared to the patients who underwent medial meniscectomy.

Abstract

Background

The collagen meniscal implant (CMI) is a biologic scaffold that could be used to replace the meniscus host tissue after partial meniscectomy. The short-term results of this procedure have already been described, however, there is a paucity of comparative long-term studies.

Purpose

The aim of the study was to compare the clinical outcomes, failures and osteoarthritis progression of patients who underwent partial medial meniscectomy and partial meniscus scaffold implantation.
Study design: Prospective cohort-study; level of evidence, 2.

Methods

Thirty-six nonconsecutive patients with medial meniscus injuries underwent medial CMI (MCMI) implantation or partial medial meniscectomy (PMM) between 1997 and 2000 and were included in a prospective study with an intermediate 10 year follow-up examination. Outcome measures at the last follow-up included the Lysholm score, visual analog scale (VAS) for pain, International Knee Documentation Committee (IKDC) knee form, and Tegner activity level. Bilateral weightbearing radiographs were also completed at final follow-up to evaluate Hip-Knee-Angle (HKA), medial Joint Line Height (JL) and the medial joint line difference between the medial joint line angles. Data regarding complications and failures were collected.

Results

At the final follow-up, 31 patients (15 MCMI, 16 PMM, 83% follow-up rate) were included in the final analysis at 21.3 years of follow-up. Two failures (1 per group) were reported: 1 Total Knee Arthroplasty and one medial meniscus transplant, therefore, the survival rate of the CMI was 93%. When comparing the clinical results of the two groups, no difference was found considering the Lysholm score (p=0.86), KOOS subscales (p= 0.45 – 0.92), Tegner (p=0.29) and the IKDC (p=0.70). Moreover, 17 patients underwent Radiographic examination (7 MCMI, 10 MM) and no significant difference was reported with respect of the presence and incidence of Osteoarthritis between the two groups.

Conclusion

The CMI implant for partial medial meniscectomy provided good long-term results and a low failure rate. However, differently from the 10 years follow-up, the clinical and the radiological outcomes were not superior compared to the medial meniscectomy group.