Abstract
Purpose
To compare the results of two meniscal scaffolds, CMI and Actifit, for the treatment of partial meniscal lesions.
Methods
A systematic review was performed on the PubMed, Web of Science, Scopus, Embase, and Cochrane databases in January 2021, including randomized controlled trails (RCTs) and prospective and retrospective observational studies on the clinical results of meniscal scaffolds. A meta-analysis of the clinical results was performed; the rate of failures was recorded, as well as radiological results. The quality of the included studies was assessed with a modified Coleman Methodology Score (CMS).
Results
The search identified 37 studies (31 in the last 10 years): 2 RCTs, 5 comparative studies, 26 prospective and 4 retrospective series on a total of 1276 patients (472 CMI, 804 Actifit). The quality of evidence was generally low. An overall significant improvement in all clinical scores was documented for both scaffolds. The meta-analysis showed no differences between the two scaffolds in terms of patient reported outcome measures and activity level. The meta-analysis on the risk of failures documented a risk of failures of 7% in the CMI and of 9% in the Actifit group.
Conclusions
There is a growing interest on the results of meniscal scaffolds, with most studies published recently. However, long-term data on the Actifit scaffold and high-level comparative studies are missing. Both CMI and Actifit offered good clinical results with a significant and comparable improvement in symptoms and function, and with a low number of failures over time. Accordingly, with the proper indication, their use may be encouraged in the clinical practice.
Level of evidence
Level IV.
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DR participated in literature review, data collection, figures editing, and manuscript writing. DP participated in literature review, data collection, and statistical analysis. LA participated in data collection, figures editing and manuscript editing. AG participated in manuscript writing and editing. CC participated in study design and manuscript editing. SZ participated in study design and manuscript editing. GF participated in study design and manuscript editing. All authors read and approved the final manuscript.
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Stefano Zaffagnini has potential conflict of interest. He has received institutional support outside the present work from Fidia Farmaceutici, Cartiheal, IGEA Clinical Biophysics, Biomet and Kensey Nash. He has received grant support outside the present work from I + and royalties from Springer. Christian Candrian has received institutional support outside the present work from Medacta International SA, Johnson & Johnson, Lima Corporate, Zimmer Biomet, and Oped AG. Other Authors declare that they have no potential conflict of interest.
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Reale, D., Previtali, D., Andriolo, L. et al. No differences in clinical outcome between CMI and Actifit meniscal scaffolds: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 30, 328–348 (2022). https://doi.org/10.1007/s00167-021-06548-1
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DOI: https://doi.org/10.1007/s00167-021-06548-1