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Outcome After Partial Medial Meniscus Substitution With the Collagen Meniscal Implant at a Minimum of 10 Years' Follow-up

2011; Elsevier BV; Volume: 27; Issue: 7 Linguagem: Inglês

10.1016/j.arthro.2011.02.018

1526-3231

Juan Carlos Monllau, Pablo Eduardo Gelber, Ferrán Abat, Xavier Pelfort, Rosa Abad, Pedro Hinarejos, Marc Tey,

Sports injuries and prevention

Purpose The aim of the study was to evaluate the clinical outcome of a collagen meniscus graft implanted in an injured medial meniscus after a minimum of 10 years' follow-up. Methods Twenty-five patients underwent arthroscopic implantation of the collagen meniscus device. They had either persistent compartmental joint line pain due to a previous medial meniscus resection (5 cases) or a large irreparable meniscus tear at arthroscopy (20 cases). Implant failure was defined as infection due to the implant or mechanical failure of the device. Twenty-two patients returned for clinical, functional, and radiographic evaluation. Magnetic resonance imaging was also performed and was analyzed with the criteria of Genovese et al. (where type 3 indicates normal and type 1 indicates completely abnormal). All the aforementioned evaluations were carried out at a minimum of 10 years (range, 10.1 to 12.5 years) after the procedure. Results The mean Lysholm score improved from 59.9 preoperatively to 89.6 at 1 year ( P < .001), and it was 87.5 at final follow-up ( P < .001). The results were good or excellent in 83% of the population. No differences were observed when we compared the Lysholm score at 1 year of follow-up with the score at final follow-up ( P > .05). The mean pain score on a visual analog scale improved by 3.5 points at final follow-up. Patient satisfaction with the procedure was 3.4 of 4 points. Radiographic evaluation showed either minimal or no narrowing of the joint line. Magnetic resonance imaging showed type 2 in 64% of cases and type 3 in 21%. All cases showed less volume than expected (size type 2 in 89%). The failure rate in the patient population was 8% (2 of 25). There were no complications related to the device. Conclusions Although there were several different types of patients and acute and chronic tears were treated in a limited number of patients, meniscal substitution with the collagen meniscal implant provides significant pain relief and functional improvement after a minimum of 10 years' follow-up. The implant generally diminished in size, but the procedure proved to be safe and had a low rate of implant failure on a long-term basis. No development or progression of degenerative knee joint disease was observed in most cases. Level of Evidence Level IV, therapeutic case series.