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Ongoing MRI remodeling 3–7 years after collagen meniscus implantation in stable knees

  • KNEE
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the present study was to evaluate the clinical and radiological 3–7 years outcomes of patients who underwent collagen meniscus implantation in stable or stabilized knees. It was the hypothesis that using the collagen meniscus (CMI) good clinical 3–7 years outcomes with low pain levels are achieved.

Methods

Thirty-nine patients (male:female = 30:9, mean age 34 ± 10 years) underwent arthroscopic CMI after subtotal medial (n = 32) or lateral meniscectomy (n = 7). A 7-mm CMI was performed due to prophylactic (n = 25) or therapeutic indication (n = 14). IKDC score, Tegner score preinjury, preoperatively and at follow-up, Lysholm score and visual analogue scale for pain and satisfaction (follow-up rate 90%) were assessed. MRI scans were analyzed according to the Genovese criteria (n = 19). Implant failure was defined as infection or mechanical failure of the device. The minimum follow-up time was 36 months (range 36–84 months).

Results

The mean VAS satisfaction preoperatively and at follow-up was 4.0 ± 0 and 1.6 ± 1.0. The mean VAS pain was 4.3 ± 3.2 preoperatively and at last follow-up 2.1 ± 1.7. The median Tegner score preinjury was 7 (range 3–10), it decreased preoperatively to median 3.5 (range 1–8) and nearly reached the preinjury level at last follow-up 6 (range 3–10). The mean Lysholm score before surgery was 66 ± 20 and 91 ± 8 at last follow-up. Seven patients (38.9%) had a normal total IKDC score (A), 10 patients were nearly normal (B) and 1 patient slightly abnormal (C). In MRI the CMI was entirely resorbed in 4 patients (21%) and partially resorbed in 15 (79%). In 4 patients (21%) the CMI was isointense, in 14 (74%) slightly hyperintense and in 1 (5%) highly hyperintense. Ten patients (53%) showed marked signs of bone marrow edema. In 13 patients (68%) an extrusion of the meniscus > 3 mm at last follow-up was found.

Conclusions

Meniscal substitution with the CMI showed good to excellent clinical 3–7 results. The CMI shows an ongoing remodelling with decreased signal intensity and decreased size. However, as meniscus extrusion remained at the same level and bone marrow edema decreased from 1 year to longer term follow-up, it appears that the remodeling comes to an end at about 5 years after CMI.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland

    L. Schenk, L. Bethge & Michael T. Hirschmann

  2. Radiology and Nuclear Medicine, University Basel Hospital, Basel, Switzerland

    A. Hirschmann

  3. Sportclinic Zürich, Zurich, Switzerland

    R. Berbig & U. Lüthi

  4. LEONARDO, Clinic Hirslanden Birshof, Münchenstein, Switzerland

    M. P. Arnold

  5. University of Basel, Basel, Switzerland

    Michael T. Hirschmann

Authors
  1. L. Schenk
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  2. L. Bethge
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  3. A. Hirschmann
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  4. R. Berbig
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  5. U. Lüthi
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  6. M. P. Arnold
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  7. Michael T. Hirschmann
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Correspondence to Michael T. Hirschmann.

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The authors declare that they have no conflict of interest.

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There was no outside funding recieved for this study.

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All investigations were conducted in conformity with ethical principles of research and that institutional approval of the human protocol for this investigation was obtained.

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Informed consent for participation in the study was obtained by the local institution.

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Schenk, L., Bethge, L., Hirschmann, A. et al. Ongoing MRI remodeling 3–7 years after collagen meniscus implantation in stable knees. Knee Surg Sports Traumatol Arthrosc 28, 1099–1104 (2020). https://doi.org/10.1007/s00167-019-05714-w

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  • DOI: https://doi.org/10.1007/s00167-019-05714-w

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