Summary

Treatment of cartilage defects with the Agili-C implant shows promising results and improvement of clinical and radiographic outcomes in patients with or without partial meniscectomy.

Abstract

Introduction

Partial meniscectomy is a common procedure for managing meniscal tears, but it often results in focal cartilage degeneration due to increased stress on the joint surfaces. The Agili-C implant, a synthetic aragonite-based scaffold, has been developed to address cartilage defects by facilitating cartilage and subchondral tissue regeneration. This study evaluates the efficacy of the Agili-C implant in patients with partial meniscectomy.

Objective

To assess clinical outcomes, including pain reduction, functional improvement, and cartilage regeneration, in patients who received the Agili-C implant following partial meniscectomy and compare to patients without meniscectomy.

Methods

This is a secondary analysis of data collected as part of a large multicenter randomized controlled trial. The analysis includes 164 patients (aged 21.2-71.8 years) with symptomatic cartilage defects in the knee who were treated with the Agili-C implant for repair of cartilage defects. We divided the patients into 4 groups: Group1 (n=12) are patients who underwent partial meniscectomy in the past and secondary partial meniscectomy at the time of Agili-C implantation, the Group 2 (n=35) are patients with primary partial meniscectomies concomitantly with Agili-C implantation. The third group (n=23) are patients who had in the past partial meniscectomy and no meniscal pathology at the time of Agili-C implantation and the fourth group (n=94) are patients with a normal meniscus and no meniscal pathology at the time of Agili-C implantation. The primary endpoint was change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) overall score. Secondary endpoints included change in all KOOS subscale scores the International Knee Documentation Committee (IKDC) score compared to baseline and MRI-based assessment of % cartilage lesion fill at 24 months post-implantation.

Results

At 48 months post-implantation, all groups showed a significant improvement of KOOS overall, KOOS subscales and IKDC scores versus baseline. There were no significant differences between the groups.
. The mean increase in KOOS overall score compared to baseline was 40.2% in Group 1, 43.3% in Group 2, 38.5% in Group 3, and 41.9% in Group 4. MRI evaluations at 24 months revealed 75% or greater defect fill in 88.5% of cases, ranging from 85.7% in Group 2 to 95.7% in Group 3,. At 48-month follow-up, 15% of all patients underwent additional treatment in the index knee (e.g., intra-articular injection or secondary surgical interventions).

Conclusion

Treatment of cartilage defects with the Agili-C implant shows promising results and improvement of clinical and radiographic outcomes in patients with or without partial meniscectomy.These results suggest that Agili-C could play a key role in preventing the progression of joint degeneration in this patient population. Further long-term studies are needed to confirm these findings and to compare the efficacy of Agili-C in meniscectomized knees.