SIMULTANEOUS ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION AND COLLAGEN MENISCAL IMPLANTATION. RESULTS OF 42 CASES WITH A MINIMUM 18 MONTHS FOLLOW UP

Abstract

Introduction: Loss of the meniscus frequently leads to progressive arthritic changes in the involved compartment. Replacement of the lost meniscus with a resorbable collagen scaffold has been proved to allow regeneration of meniscal tissue.

MATERIAL AND Methods: Between June 2001 and September 2004, 42 patients, 38 male and 4 female, underwent arthroscopic placement of a collagen meniscus implant (CMI) to reconstruct the damaged medial meniscus. Their age ranged between 22 and 50 years. All patients had an associated ACL insufficiency, 39 secondary to acute ACL tear and 3 ACL graft failures. ACL reconstruction with hamstrings grafts (39) and ACL revision with allograft (3) was performed at the time of CMI implantation. The interval between ACL injury and surgery ranged between 3 weeks and 6 months. Ten patients also had a lateral meniscus tear. All patients were followed with clinical, weight-bearing radiographs, KT-1000 and magnetic resonance examinations for at least 18 months (range, 18– 84 months). The IKDC form was used to record and evaluate the Results:

Results: The length of the implanted CMI ranged between 3 and 5.5 cm and required 4 to 8 stiches.

The IKDC subjective evaluation was normal in 18 patients, nearly normal in 18, abnormal in 5 and severely abnormal in 1. Range of motion was normal in 28 patients and nearly normal in 14. KT 1000 examination was normal in 32 patients, nearly normal in 7, abnormal in 1 and severely abnormal in 2.

The X ray findings were normal in 28 patients, nearly normal in 6 and abnormal in 8.

Complications included 2 saphenous nerve neuritis, 1 ACL graft tear with CMI implant breakage and 2 knee stiffness that required mobilization.

40 patients returned to work. The average time to resume work was 5.5 months

Conclusion: Simultaneous ACL reconstruction and collagen meniscal implantation is a viable and effective option in young active patients with ACL insufficiency and associated meniscal injuries.