DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING FINDINGS FOLLOWING IMPLANTATION OF A NOVEL MENISCUS SCAFFOLD

Abstract

Introduction: Partial and total meniscectomy has been shown to result in cartilage degeneration and osteoarthritis in the long term. Thus, research efforts have focused on tissue regeneration following meniscectomy. A novel device has recently been developed which, when implanted in the meniscus, provides a three-dimensional honeycombed matrix for vascular ingrowth and tissue regeneration to replace lost meniscus tissue. To evaluate this vascular ingrowth and tissue regeneration a Dynamic contrast-enhanced MRI non invasive technique was used.

Methods: A prospective, non-randomised, single-arm, multi-centre, clinical investigation was conducted in 52 patients with an irreparable medial or lateral meniscal tear or partial meniscus loss, with intact rim. Patients were required to have a stable knee joint or be a candidate for knee joint stabilization within 12 weeks of the index procedure, have an International Cartilage Repair Society (ICRS) classification of Grade I or II, and have undergone no more than 3 previous surgeries on the index knee. Following implantation of the novel scaffold, dynamic contrast-enhanced magnetic resonance imaging (DCMRI) using intravenous gadolinium contrast material was performed at 1 week, and at 3 and 12 months post-implantation. Because the scaffold and normal meniscus tissue lack vascularity, the presence of signal enhancement in the device is an appropriate surrogate for the ingrowth of blood vessels and native tissue into the scaffold. All scans were assessed for neovascularization in the scaffold meniscus and integration of the implanted device. To date DCMRI scans at 3 months are available for 48 of the 52 patients. Full data for all available patients will be presented.

Results: Using this non-invasive technique evaluable DCMRI data at 3 months were obtained for 42 of the 48 patients (87.5%), showing vascularity, and therefore the presence of tissue, in 35 of the 48 (72.9%) patients. No enhancement (vascularity) was demonstrated in 6 of the 48 (12.5%) patients.

Conclusions: At 3 months post-implantation, vascularization, and therefore tissue ingrowth, was demonstrated using DCMRI in the vast majority of patients treated with the novel meniscus scaffold.