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Placement of a polyurethane implant is not associated with a chondroprotective effect: comparative study with cases of isolated medial meniscectomy with at least five years of follow-up

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Our main objective was to evaluate clinically and radiologically and compare patients who had undergone partial meniscectomy alone, with those who had received a partial meniscectomy in which a polyurethane implant was placed, with a minimum follow-up of 5 years.

Methods

We performed a prospective cohort study. Patients were randomly distributed into Group A if they only received meniscectomy or Group B if they received meniscectomy plus a meniscal implant (Actifit®). We performed preoperative, postoperative, and 5-year-follow-up functional and radiological evaluations (magnetic resonance imaging).

Results

Twelve patients (40%) were treated with meniscal implants (Group B); 18 (60%) were treated with a conventional meniscectomy (Group A). Tegner, Lysholm and KOOS scores were evaluated prior to surgery and at 5-year follow-up. Only the Lysholm score showed a significant difference between groups, with a score increase between the preoperative evaluation and the 5-year follow-up evaluation (p = 0.013). Preoperative and postoperative MRIs were both available in 19 cases (63.3%). Long-term follow-up MRIs were performed in 11 cases of group B. No significant differences were found in functional outcomes or MRI findings (WORMS cartilage score increase p = 0.360). Although total reabsorptions of the collagen meniscus implant were not statistically significant in younger patients, a tendency towards a higher reabsorption process was seen in older patients (p = 0.015).

Conclusion

The placement of a polyurethane implant after a wide meniscectomy is not accompanied by a chondroprotective effect over time. There is no functional difference between implant placement and isolated meniscectomy. There is a discrepancy between good clinical results and radiologic appearance of these implants and their underlying cartilage.

Level of evidence

II, therapeutic study.

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Funding

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Authors and Affiliations

  1. Knee Unit, Department of Orthopaedic Surgery, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain

    Marta Sabater-Martos & Dragos Popescu

  2. Department of Orthopaedic Surgery, Hospital Clínic de Barcelona, Carrer Villarroel 170, Barcelona, Spain

    Clara Chimeno-Pigrau

  3. Spine Unit, Department of Orthopaedic Surgery, Hospital Clínic de Barcelona, Barcelona, Spain

    Eduard Tornero Dacasa

  4. Artrhoscopy and Upper Limb Unit, Department of Orthopaedic Surgery, Hospital Clínic de Barcelona, Barcelona, Spain

    Sergi Sastre Solsona

  5. Musculoeskeletal Radiology Unit, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain

    Jaime Isern Kebschull

Authors
  1. Marta Sabater-Martos
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  2. Clara Chimeno-Pigrau
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  3. Eduard Tornero Dacasa
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  4. Sergi Sastre Solsona
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  5. Jaime Isern Kebschull
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  6. Dragos Popescu
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Contributions

DP conceived the study and participated in its design and coordination and helped draft the manuscript, he also performed the surgeries. MSM helped performed the statistical analysis and drafted the manuscript. CCP carried out data collection and helped draft the manuscript. ETD performed the statistical analysis. SSS conceived the study and performed the surgeries. JIK evaluated all the MRI. All authors read and approved the final version.

Corresponding author

Correspondence to Clara Chimeno-Pigrau.

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The authors declare no conflict of interests.

Ethical approval

CEIC number 2010/6038.

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Informed consent was obtained from all individual participants included in the study.

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Sabater-Martos, M., Chimeno-Pigrau, C., Tornero Dacasa, E. et al. Placement of a polyurethane implant is not associated with a chondroprotective effect: comparative study with cases of isolated medial meniscectomy with at least five years of follow-up. Arch Orthop Trauma Surg 143, 3213–3218 (2023). https://doi.org/10.1007/s00402-022-04664-2

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  • DOI: https://doi.org/10.1007/s00402-022-04664-2

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