Treatment of meniscal lesions is the most common surgical intervention performed by orthopaedic surgeons today. Favorable results have been reported in the short term after partial meniscectomy. However, the risk of osteoarthritis and irreversible damage occurring in the long term remains. Therefore, a novel, biodegradable, polyurethane scaffold was developed to fulfill an unmet clinical need in the treatment of patients with presenting with painful irreparable partial meniscal defects.
One hunderd and sixty four patients were consecutively treated for their partial meniscusdefects with the scaffold technique (Actifit). One hundert and fifty five patients were prospectively clinically evaluated with a follow-up of minimum 60 months. Magnetic resonance imaging (MRI) was used for morphologic analysis of the meniscal regeneration at 12, 24 and 60 months of follow-up.
The patients included in this study showed a significant gradual clinical improvement after implantation of the scaffold. No effect of the scaffold on the opposing cartilage was observed on MRI. In 23 patients the treatment had failed (16,8%). Eighteen patients were lost to follow-up (11 %).
At five years post implantation, clinical outcome data from this study support the use of the polyurethane scaffold for the treatment of irreparable, painful, partial meniscus defects. However, well-designed, large-scale, randomized controlled trials are mandatory to confirm the initial results and the reliability of this procedure.