N. Shabshin (Ra'anana, IL)
Hospital of University of Pennsylvania Diagnostic ImagingPresenter Of 1 Presentation
10.3.11 - Two-Year MRI Follow-Up on Medial Compartment Cartilage: Superiority of Implanted Synthetic Medial Meniscus Over Non-Surgical Care
Abstract
Purpose
This study aims to compare the medial compartment cartilage condition in patients implanted with a NUsurface to non-surgical controls, on a 2-year follow-up MRI.
Methods and Materials
Population: 242 subjects with a history of partial meniscectomy of at least 6 months, suffering from knee pain (176 NUsurface implanted, 66 non-surgical care). Methods: A randomized controlled superiority trial compared the medial compartment cartilage condition in NUsurface patients and controls on a 2-year follow-up MRI. Evaluation of the cartilage was obtained using a Outerbridge method1. Cartilage lesions were classified to full-thickness and non-full-thickness lesions (partial thickness defects or no morphological cartilage defects). Statistical analysis was conducted using Fisher’s exact test.
Results
At 2-year follow-up 17/116 (14.7%) NUsurface patients and 14/32 (43.8%) controls deteriorated from non-full thickness to full-thickness lesions in the medial compartment (P=0.001). At baseline, both groups presented similar proportions of full-thickness cartilage defects in the medial femoral condyle (MFC) (26.6% vs 25.6%) (p>0.05) and at 2-years follow-up full-thickness defects were seen in 33/158 (20.9%) of implanted patients vs 24/43 (55.8%) in controls. After 2-years, improvement in the MFC cartilage was significantly higher in implanted patients vs controls (26/42 (61.9%):1/11 (9.1%), respectively (p=0.002)). There was no significant difference in the MTP results.
Conclusion
Two-year results from the FDA-regulated clinical trial demonstrate that the NUsurface implant provides superior protection of the medial compartment cartilage, specifically the MFC, in post meniscectomy patients, when compared to non-surgical care. By reducing or slowing cartilage deterioration, utilizing a replaceable synthetic meniscus, total knee arthroplasty may be delayed.