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Knee Surg Sports Traumatol Arthrosc. 2015 Jan;23(1):334-9. doi: 10.1007/s00167-014-3206-z. Epub 2014 Jul 29.

Partial meniscus substitution with a polyurethane scaffold does not improve outcome after an open-wedge high tibial osteotomy.

Author information

1
ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, c/Sabino de Arana 5-19, 08028, Barcelona, Spain, pablogelber@gmail.com.

Abstract

PURPOSE:

The aim of the study was to determine whether medial meniscal substitution with a polyurethane scaffold (Actifit(®)) improves the outcome of medial meniscal-deficient varus knees undergoing open-wedge high tibial osteotomy.

METHODS:

Sixty patients with symptomatic varus knees those who underwent open-wedge high tibial osteotomies were prospectively studied. In 30 patients, the medial meniscus was left with a defect larger than 25 mm (Group M). An Actifit(®) device was implanted (Group A) in the remaining 30 patients. Patients were functionally evaluated with WOMET, IKDC and VAS. Patient satisfaction was graded from 0 (not satisfied) to 4 (very satisfied).

RESULTS:

Both groups were comparable preoperatively. They had similar follow-up periods (31.2 months; range 24-47.5; n.s.). WOMET improved a mean of 53.4 ± 8.4 and 42.4 ± 17.2 points in Groups M and A, respectively (p = 0.002). IKDC improved a mean of 56.7 ± 12 and 50.3 ± 15.6 points in Groups M and A, respectively (n.s.). VAS dropped 5.9 ± 2.1 and 4.7 ± 2.8 points in Groups M and A, respectively (p = 0.006). Patient satisfaction averaged 3.3 ± 0.8 and 3.3 ± 1 in Groups M and A, respectively (n.s.).

CONCLUSIONS:

Patients with symptomatic varus knees were treated with open-wedge high tibial osteotomies, and a meniscectomy was improved more at short-term follow-up in most of the evaluated functional scores than those patients with concomitant implantation of a medial Actifit(®) implant. However, there was no difference in terms of patient satisfaction with the procedure. Based on the short-term functional results of this study, no data were provided to support medial meniscal substitution with a polyurethane scaffold when an open-wedge high tibial osteotomy is being performed.

LEVEL OF EVIDENCE:

Prospective comparative study, Level II.

PMID:
25069570
DOI:
10.1007/s00167-014-3206-z
[Indexed for MEDLINE]

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