Implant méniscal en polyuréthane pour méniscetomie douleureuse chronique. Résultats à 5 ans

Abstract

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. Fourty-three patients were consecutively treated for their partial meniscus defects with the scaffold technique (Actifit). These patients were prospectively clinically evaluated with a follow-up of 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 thirteen patients, the treatment had failed (30.2%). Six patients were lost to follow-up (13.9%). 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.