Background: At least 760,000 outpatient meniscectomies are performed in the United States each year, making this the most common musculoskeletal procedure. However, meniscal resection can alter the joint biomechanics and overload the articular cartilage, which may contribute to degenerative changes and the need for knee replacement. Avoiding or delaying knee replacement is particularly important in younger or more active patients. Synthetic meniscal implants have been developed in an attempt to restore the natural joint biomechanics, alleviate pain and disability, and potentially minimize degenerative changes in patients who require meniscectomy.
Purpose: To evaluate the preliminary results from 2 ongoing trials that are evaluating the safety and effectiveness of a synthetic polymer meniscal implant (NUsurface; Active Implants, LLC).
Study Design: Cohort study; Level of evidence, 2.
Methods: This was a preliminary analysis of the first 100 patients enrolled across 2 studies for 12 months: a single-arm, intervention-only study and a randomized controlled trial comparing the investigational meniscal implant with nonsurgical therapy. There were 65 patients in the implant group (30 randomized) and 35 in the control group. Outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) and adverse events (AEs) collected at baseline and follow-up visits of 6 weeks, 6 months, and 12 months.
Results: No statistically significant differences were found in baseline characteristics between the implant and control groups. At 12 months, follow-up KOOS data were available for 87% of the 100 included patients. Significantly greater improvements from baseline were observed in the implant group compared with controls in all KOOS subcomponents, except for symptoms (119%-177% greater improvement at 12 months). AEs were reported at similar rates between the 2 groups, with 12 AEs among 11 patients in the implant group (16.9%) versus 5 AEs among 5 patients (14.3%) in the control group ( = .99).
Conclusion: These preliminary results suggest significant improvements in pain and function scores with the implant over nonsurgical therapy and a similar adverse event rate.
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http://dx.doi.org/10.1177/2325967120952414 | DOI Listing |
Arthrosc Tech
November 2024
Arthroscopy and Arthroplasty Unit, RNH Hospital, Nagpur, India.
Anterior cruciate ligament avulsion fractures are more commonly seen in children with open physes than in adults. Arthroscopic fixation is considered the gold standard in the management of such injuries. Our technique of anterior-row fixation for these injuries provides various advantages in the form of physeal-sparing, complete anatomic reduction with no anterior beaking, no arthrofibrosis, no residual instability, no intra-articular hardware, no need for a second operation to remove implants, and finally, a full range of movement with no loss of extension.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
December 2024
Ramsay Santé, Hôpital Privé d'Antony, 1 rue Velpeau, 92160 Antony, France.
Introduction: Patellar instability is a multifactorial pathology requiring precise evaluation of its contributing factors, particularly patella alta. Patellotibial height measurement indexes, such as the Caton-Deschamps index, have the disadvantage of being referenced to the tibia. Patellotrochlear indexes are more appropriate but fail to account for variable knee flexion during magnetic resonance imaging (MRI).
View Article and Find Full Text PDFJ Orthop Res
December 2024
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Magnetic resonance imaging (MRI) of the knee is the recommended diagnostic method before invasive arthroscopy surgery. Nevertheless, interpreting knee MRI scans is a time-consuming process that is vulnerable to inaccuracies and inconsistencies. We proposed a multitask learning network MCSNet which efficiently introduces segmentation prior features and enhances classification results through multiscale feature fusion and spatial attention modules.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
February 2025
Centre for Regenerative Medicine, Department for Health Science, University for Continuing Education Krems, Krems an der Donau, Austria; Austrian Cluster for Tissue Regeneration, Austria.
Objective: To investigate the suitability of different material compositions and structural designs for 3D-printed meniscus implants using finite element analysis (FEA) to improve joint function after meniscal injury and guide future implant development.
Design: This experimental study involved in-silico testing of a meniscus model developed from two materials: a specially formulated hydrogel composed of silk fibroin (SF), gelatine, and decellularized meniscus-derived extracellular matrix (MD-dECM), and polyurethane (PU) with stiffness levels of 54 and 205 MPa. Both single-material implants and a two-volumetric meniscus model with an SF/gelatine/MD-dECM core and a PU shell were analysed using FEA to simulate the biomechanical performance under physiological conditions.
Arthroscopy
November 2024
Advanced Orthopedic Sports Medicine Specialists Denver, Colorado, U.S.A.
Purpose: To evaluate the clinical outcomes in the use of a synthetic medial meniscus implant in patients symptomatic after medial meniscectomy and not responsive to nonoperative treatment.
Methods: This single-arm, multicenter, prospective study enrolled subjects between ages 30 and 75 with postmeniscectomy pain. Changes from baseline to 24 months were measured in the pain subscale of the knee injury and osteoarthritis outcome score (KOOS) and in KOOS overall (average of all 5 subscales) in patients that had received a medial meniscus implant.
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