Abstract
We report the clinical results and MRI findings observed in 50 patients who underwent collagen meniscus implant (CMI) between March 2001 and October 2003. Fifty patients affected by irreparable meniscal lesions or who had previously undergone partial medial meniscectomy were arthroscopically treated with CMI, a tissue engineering technique designed to promote meniscal regeneration. Average age at the time of surgery was 38.4 years. The average size of the lesion/defect was 4.3 cm. Additional procedures included 16 ACL reconstructions, eight high tibial osteotomies and two autologous chondrocyte implantations. All knees were evaluated according to the Lysholm II and Tegner activity scales. MRI was performed 6, 12 and 24 months postoperatively. Six arthroscopic examinations of the implant were performed at different times (6 to 16 months postoperatively).
Postoperative complications included saphenus neuroapraxia in three patients and CMI rupture in one patient who presented with persistent knee swelling. Follow-up averaged 16.5 months, with a minimum of 6 months. At the most recent evaluation, 46 patients showed an improvement in the clinical scores. A progressive, uniform signal was evident by MRI. At the second arthroscopic study, free fragments of the implant were observed in cases of CMI rupture. In another patient, partial resorption of CMI was observed at the posterior horn. The remaining four arthroscopic examinations demonstrated regeneration of meniscal-like tissue.
Clinical results achieved with CMI are promising. MRI proved to be an effective tool for monitoring the evolution of the implant and showed good correlation with clinical outcomes and arthroscopic findings at follow-up.
