Ongoing MRI remodeling 3-7 years after collagen meniscus implantation in stable knees
| Autor: | L Bethge, U. Lüthi, Anna Hirschmann, R. Berbig, Markus P. Arnold, Michael T. Hirschmann, L. Schenk |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual analogue scale Pain Meniscus (anatomy) Decreased size Menisci Tibial Prosthesis Implantation 03 medical and health sciences Arthroscopy 0302 clinical medicine Postoperative Complications Medicine Edema Humans Orthopedics and Sports Medicine Orthopedic Procedures Bone Marrow Diseases Meniscectomy Pain Measurement 030222 orthopedics business.industry Cartilage Mechanical failure Implant failure 030229 sport sciences Bone marrow edema Magnetic Resonance Imaging Surgery Tibial Meniscus Injuries medicine.anatomical_structure Treatment Outcome Orthopedic surgery Female Collagen business Follow-Up Studies |
| Zdroj: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 28(4) |
| ISSN: | 1433-7347 |
| Popis: | The purpose of the present study was to evaluate the clinical and radiological 3–7 years outcomes of patients who underwent collagen meniscus implantation in stable or stabilized knees. It was the hypothesis that using the collagen meniscus (CMI) good clinical 3–7 years outcomes with low pain levels are achieved. Thirty-nine patients (male:female = 30:9, mean age 34 ± 10 years) underwent arthroscopic CMI after subtotal medial (n = 32) or lateral meniscectomy (n = 7). A 7-mm CMI was performed due to prophylactic (n = 25) or therapeutic indication (n = 14). IKDC score, Tegner score preinjury, preoperatively and at follow-up, Lysholm score and visual analogue scale for pain and satisfaction (follow-up rate 90%) were assessed. MRI scans were analyzed according to the Genovese criteria (n = 19). Implant failure was defined as infection or mechanical failure of the device. The minimum follow-up time was 36 months (range 36–84 months). The mean VAS satisfaction preoperatively and at follow-up was 4.0 ± 0 and 1.6 ± 1.0. The mean VAS pain was 4.3 ± 3.2 preoperatively and at last follow-up 2.1 ± 1.7. The median Tegner score preinjury was 7 (range 3–10), it decreased preoperatively to median 3.5 (range 1–8) and nearly reached the preinjury level at last follow-up 6 (range 3–10). The mean Lysholm score before surgery was 66 ± 20 and 91 ± 8 at last follow-up. Seven patients (38.9%) had a normal total IKDC score (A), 10 patients were nearly normal (B) and 1 patient slightly abnormal (C). In MRI the CMI was entirely resorbed in 4 patients (21%) and partially resorbed in 15 (79%). In 4 patients (21%) the CMI was isointense, in 14 (74%) slightly hyperintense and in 1 (5%) highly hyperintense. Ten patients (53%) showed marked signs of bone marrow edema. In 13 patients (68%) an extrusion of the meniscus > 3 mm at last follow-up was found. Meniscal substitution with the CMI showed good to excellent clinical 3–7 results. The CMI shows an ongoing remodelling with decreased signal intensity and decreased size. However, as meniscus extrusion remained at the same level and bone marrow edema decreased from 1 year to longer term follow-up, it appears that the remodeling comes to an end at about 5 years after CMI. IV. |
| Databáze: | OpenAIRE |
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