Purpose
To compare, at long-term follow-up, the clinical outcomes and failures of collagen
and polyurethane meniscal scaffolds for the treatment of partial meniscal defects.
Methods
Patients affected by partial meniscal defect with intact anterior and posterior meniscal
attachments and an intact rim at the circumference of the missing meniscus were included,
treated with a collagen meniscal implant or with polyurethane scaffold, and clinically
evaluated by analysis of the subjective International Knee Documentation Committee
score, the visual analog scale score for the evaluation of knee function and symptoms,
and the Tegner score to assess the activity level.
Results
After 3 patients dropped out, a total of 47 patients, comprising 31 men and 16 women,
with a mean age of 43 ± 14.1 years and mean body mass index of 25 ± 1.4, were clinically
evaluated up to a mean of 10 years’ follow-up. The International Knee Documentation
Committee score improved from 42.9 ± 15.9 to 67.4 ± 12.4 (P < .0005) in the polyurethane implant group and from 46.8 ± 16.7 to 62.1 ± 22.6 (P < .0005) in the collagen meniscal implant group. The visual analog scale score decreased
significantly from baseline values of 5.4 ± 2.3 and 4.4 ± 1.7, to 3.4 ± 2.5 and 2.7
± 2.4, respectively, at final follow-up in the polyurethane implant (P = .002) and collagen meniscal implant (P < .0005) groups. The Tegner score improved in both groups without reaching the preinjury
activity level. No significant differences in the scores were found between the polyurethane
and collagen scaffold groups. A total of 10 implants failed, 5 per group, for a cumulative
failure rate of 21.3%, with no differences between the 2 scaffolds.
Conclusions
The long-term comparison showed positive and similar results for both polyurethane-
and collagen-based meniscal scaffolds, with an implant survival rate of about 80%
at 10 years of follow-up and no differences in terms of pain, function, and activity
level.
Level of evidence
Level IV, case-control comparative study.
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Article info
Publication history
Published online: September 24, 2021
Accepted:
September 7,
2021
Received:
May 13,
2021
Footnotes
G.F. and S.Z. equally share senior authorship.
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Funding: This study received no external funding.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
