Skip to main content
SpringerLink
Log in

Collagen meniscus implantation: a systematic review including rehabilitation and return to sports activity

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To determine collagen meniscus implant (CMI) efficacy for improving patient function, symptoms, and activity level. Study methodologies, rehabilitation, and return to sports guidelines were also reviewed.

Methods

MedLine, EMBASE, CINAHL, Life Science Citations, and Cochrane Central Register of Controlled Trials databases were searched from January 1995–May 2011 using the term collagen meniscal or meniscus implant. Only human studies with English language abstracts that reported patient outcomes were included. Modified Coleman Methodology criteria were used to score research quality.

Results

Eleven studies with 520 subjects (men = 428; women = 92; 17.7% women) of 38.2 ± 3.7 years of age met the inclusion criteria. Of these subjects, 321 (men = 263, women = 58; 18.1% women) received a CMI. Based primarily on Lysholm Knee Score, Tegner Activity Scale, pain scales and self-assessment measurements knee function, symptoms, and activity level generally improved by 46.6 ± 39.9 months post-surgery. Rehabilitation was described in 9/11 (81.8%) studies and four released patients to full activities at 6 months post-surgery. No study described how advanced rehabilitation or function testing contributed to return to activity decision-making. Research quality was generally low (67.1 ± 18.6) with widely ranging (29–97) scores. Reduced CMI size at last follow-up was reported in 6/11 (54.5%) studies, but the significance of this finding is unknown.

Conclusions

Knee function, symptoms, and activity level generally improved following CMI use, but poor research report quality was common. Additional well-designed long-term prospective studies are needed to better determine knee osteoarthrosis prevention efficacy and appropriate patient selection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Benthien JP, Schwaninger M, Behrens P (2010) We do not have evidence based methods for treatment of cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 19:543–552

    Article  PubMed  Google Scholar 

  2. Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705

    Article  PubMed  Google Scholar 

  3. Bulgheroni P, Murena L, Ratti C, Bulgheroni E, Ronga M, Cherubino P (2009) Follow-up of collagen meniscus implant patients: clinical, radiological, and magnetic resonance imaging results at 5 years. Knee 17:224–229

    Article  PubMed  Google Scholar 

  4. Buma P, van Tienen T, Veth R (2007) The collagen meniscus implant. Expert Rev Med Device 4:507–516

    Article  Google Scholar 

  5. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Scand J Med Sci Sports 10:2–11

    Article  PubMed  CAS  Google Scholar 

  6. Crawford K, Briggs KK, Rodkey WG, Steadman JR (2007) Reliability, validity, and responsiveness of the IKDC score for meniscus injuries of the knee. Arthroscopy 23:839–844

    Article  PubMed  Google Scholar 

  7. Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633

    PubMed  CAS  Google Scholar 

  8. Genovese E, Angeretti MG, Ronga M et al (2007) Follow-up of collagen meniscus implants by MRI. Radiol Med 112:1036–1048

    Article  PubMed  CAS  Google Scholar 

  9. Jakobsen RB, Engebretsen L, Slauterbeck JR (2005) An analysis of the quality of cartilage repair studies. J Bone Joint Surg Am 87:2232–2239

    Article  PubMed  Google Scholar 

  10. Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Reliability, validity, and responsiveness of the Lysholm Knee Scale for various chondral disorders of the knee. J Bone Joint Surg Am 86:1139–1145

    PubMed  Google Scholar 

  11. Linke RD, Ulmer M, Imhoff AB (2006) Replacement of the meniscus with a collagen implant [CMI]. Oper Orthop Traumatol 18:453–462

    Article  PubMed  Google Scholar 

  12. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on the use of a scoring scale. Am J Sports Med 10:150–154

    Article  PubMed  CAS  Google Scholar 

  13. Menaflex Collagen Meniscus Implant (2006) Rehabilitation program summary for patients, surgeons, and physiotherapists. ReGen Biologics, Inc., Franklin Lakes, NJ, USA

  14. Reguzzoni M, Manelli A, Ronga M, Raspanti M, Grassi FA (2005) Histology and ultrastructure of a tissue-engineered collagen meniscus before and after implantation. J Biomed Mater Res Part B Appl Biomater 74B:808–816

    Article  CAS  Google Scholar 

  15. Rodkey WG, DeHaven KE, Montgomery WH III et al (2008) Comparison of the collagen meniscus implant with partial meniscectomy. A prospective randomized trial. J Bone Joint Surg Am 90:1413–1426

    Article  PubMed  Google Scholar 

  16. Rodkey WG, Steadman JR, Li S-T (1999) A clinical study of collagen meniscus implants to restore the injured meniscus. Clin Orthop Relat Res 367(Suppl):S281–S292

    Google Scholar 

  17. Ronga M, Grassi FA, Manelli A, Bulgheroni P (2006) Tissue engineering techniques for the treatment of a complex knee injury. Arthroscopy 22:576e.1–576.e3

    Google Scholar 

  18. Steadman JR, Rodkey WG (2005) Tissue-engineered collagen meniscus implants: 5- to 6-year feasibility study results. Arthroscopy 21:515–525

    Article  PubMed  Google Scholar 

  19. Stone KR, Steadman JR, Rodkey WG, Li S-T (1997) Regeneration of meniscal cartilage with use of a collagen scaffold. Analysis of preliminary data. J Bone Joint Surg Am 79:1770–1777

    PubMed  CAS  Google Scholar 

  20. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49

    PubMed  Google Scholar 

  21. van Tienen TG, Hannink G, Buma P (2009) Meniscus replacement using synthetic materials. Clin Sports Med 28:143–156

    Article  PubMed  Google Scholar 

  22. Zaffagnini S, Giordano G, Vascellari A et al (2007) Arthroscopic collagen meniscus implant results at 6 to 8 years follow up. Knee Surg Sports Traumatol Arthrosc 15:175–183

    Article  PubMed  Google Scholar 

  23. Zaffagnini S, Marcheggiani Muccioli GM, Lopomo N et al (2011) Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy. A minimum 10-years follow-up study. Am J Sports Med 39:977–985

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, 210 East Gray Street, Suite 1003, Louisville, KY, 40202, USA

    Andrew Harston, John Nyland, Emily Brand, Mark McGinnis & David N. M. Caborn

Authors
  1. Andrew Harston
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John Nyland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily Brand
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark McGinnis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David N. M. Caborn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Nyland.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harston, A., Nyland, J., Brand, E. et al. Collagen meniscus implantation: a systematic review including rehabilitation and return to sports activity. Knee Surg Sports Traumatol Arthrosc 20, 135–146 (2012). https://doi.org/10.1007/s00167-011-1579-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1579-9

Keywords

Search

Navigation