A comparison between Polyurethane and Collagen Meniscal Scaffold for Partial Meniscal Defects: Similar positive clinical results at a mean of 10-Years of Follow-up

PURPOSE: The aim of this study was to compare at long-term follow-up the clinical outcome and failures of collagen and polyurethane meniscal scaffolds for the treatment of partial meniscal defects.

METHODS: Patients affected by meniscal loss greater than 25%, with intact anterior and posterior meniscus attachments, and intact rim at the circumference of the missing meniscus were included, treated with Collagen Meniscal Implant or with polyurethane scaffold and clinically evaluated analyzing the subjective International Knee Documentation Committee (IKDC) score, the Visual analog scale (VAS) for the evaluation of knee function and symptoms, and Tegner score for the activity level.

RESULTS: Three patients dropped out, then a total of 47 patients, 31 men and 16 women with a mean age of 43 ± 14.1 years and a 25 ± 1.4 mean BMI were clinically evaluated up to a mean 10-year follow-up. The IKDC score improved in the polyurethane implant group from 42.9 ± 15.9 to 67.4 ± 12.4 (p < 0.0005) and in the Collagen Meniscal Implant group from 46.8 ± 16.7 to 62.1 ± 22.6 (p < 0.0005). VAS decreased significantly from the baseline values of 5.4 ± 2.3 and 4.4 ± 1.7 to 3.4 ± 2.5 and 2.7 ± 2.4 at final follow-up in Actifit (p = 0.002) and CMI (p < 0.0005) groups, respectively. Tegner improved in both groups without reaching the pre-injury activity level. No significant differences in the scores were found between polyurethane scaffold and collagen scaffold groups. Ten implants failed, 5 per group, for a cumulative failure rate of 21.3% and no differences between the two scaffolds CONCLUSIONS: The long-term comparison showed positive and similar results for both polyurethane and collagen-based meniscus scaffolds, with about 80% implant survival at 10 years of follow-up and not differences in terms of pain, function, and activity level.