Improvement in outcomes after implantation of a novel polyurethane meniscal scaffold for the treatment of medial meniscus deficiency

Verfasser / Beitragende:
[Karl Schüttler, Steffen Pöttgen, Alan Getgood, Marga Rominger, Susanne Fuchs-Winkelmann, Philip Roessler, Ewgeni Ziring, Turgay Efe]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/7(2015-07-01), 1929-1935
Format:
Artikel (online)
ID: 605457344
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024 7 0 |a 10.1007/s00167-014-2977-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2977-6 
245 0 0 |a Improvement in outcomes after implantation of a novel polyurethane meniscal scaffold for the treatment of medial meniscus deficiency  |h [Elektronische Daten]  |c [Karl Schüttler, Steffen Pöttgen, Alan Getgood, Marga Rominger, Susanne Fuchs-Winkelmann, Philip Roessler, Ewgeni Ziring, Turgay Efe] 
520 3 |a Purpose: Meniscal injury resulting in segmental loss of meniscal tissue is a major risk factor for the development of osteoarthritis. Tissue engineering strategies have provided scaffolds for meniscal regeneration in order to establish a treatment option for patients with limited opportunities for meniscal reconstruction. The purpose of this study was to assess the clinical and magnetic resonance imaging (MRI) results 2years after implantation of a polyurethane scaffold for chronic segmental medial meniscus deficiency following partial medial meniscectomy. Methods: Eighteen patients were treated with arthroscopic implantation of an ActiFit® (Orteq Sports Medicine) polyurethane meniscal scaffold for meniscus deficiency of the medial meniscus. Patients were followed up at 6, 12, and 24months. Clinical outcome was assessed using patient-reported outcome scores (KOOS, KSS, UCLA activity scale, VAS for pain). Radiological outcome was assessed using MRI at 6, 12, and 24months by evaluating scaffold morphology, scaffold integration, and additional joint injury, as well as joint inflammation. Results: Eighteen patients with a median age of 32.5years (range 17-49) were enrolled. Statistically significant improvements were present in all patients, but one at 2years compared to baseline in all categories. Complete resorption of the scaffold occurred in one patient representing a failure to treatment. MRI showed abnormal signal intensity of the scaffold when compared to residual meniscal tissue but without synovitis or joint inflammation. Extrusion of the scaffold was present in four patients. No correlation between scaffold extrusion and clinical outcome was observed. Conclusion: Arthroscopic implantation of a polyurethane meniscal scaffold in patients with chronic segmental medial meniscus deficiency is not only a safe procedure but leads to good clinical results at a 2-year follow-up. Scaffold extrusion did not appear to affect clinical outcome. Level of evidence: IV. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Actifit  |2 nationallicence 
690 7 |a Meniscus  |2 nationallicence 
690 7 |a Biodegradable scaffold  |2 nationallicence 
690 7 |a MRI  |2 nationallicence 
690 7 |a Polyurethane scaffold  |2 nationallicence 
690 7 |a Partial meniscectomy  |2 nationallicence 
690 7 |a Irreparable meniscal defect  |2 nationallicence 
700 1 |a Schüttler  |D Karl  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
700 1 |a Pöttgen  |D Steffen  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
700 1 |a Getgood  |D Alan  |u Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON, Canada  |4 aut 
700 1 |a Rominger  |D Marga  |u Department of Radiology, University Hospital Marburg, Marburg, Germany  |4 aut 
700 1 |a Fuchs-Winkelmann  |D Susanne  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
700 1 |a Roessler  |D Philip  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
700 1 |a Ziring  |D Ewgeni  |u Department of Trauma, Hand and Reconstructive Surgery, University Hospital Marburg, Marburg, Germany  |4 aut 
700 1 |a Efe  |D Turgay  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1929-1935  |x 0942-2056  |q 23:7<1929  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2977-6  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2977-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Schüttler  |D Karl  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Pöttgen  |D Steffen  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Getgood  |D Alan  |u Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Rominger  |D Marga  |u Department of Radiology, University Hospital Marburg, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fuchs-Winkelmann  |D Susanne  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Roessler  |D Philip  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ziring  |D Ewgeni  |u Department of Trauma, Hand and Reconstructive Surgery, University Hospital Marburg, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Efe  |D Turgay  |u Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1929-1935  |x 0942-2056  |q 23:7<1929  |1 2015  |2 23  |o 167