Purpose: To report the clinical outcomes, radiologic evolution, and survivorship of a series of patients affected by the postmeniscectomy syndrome and treated with a polyurethane scaffold at a minimum 10-year follow-up. In addition, the radiologic evolution of these patients was also assessed.
Methods: All the patients operated on with a polyurethane meniscal scaffold implantation to treat postmeniscectomy syndrome from 2008 to 2011 were prospectively followed.
Clinical evaluations and radiologic studies were assessed at the preoperative period, at 5-year follow-up, and at minimum 10-year follow-up. Clinical outcomes were based on patient-reported outcomes (e.g., the Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee, Lysholm, and Tegner). Radiographical evaluation of the joint-space narrowing was done in the Rosenberg view. Failure was defined as patients who required
surgery to remove the scaffold or those patients who needed surgery for a total or partial knee replacement.
Results: Twenty-one of 27 patients, with a mean age of 56 9.8 years, were available for the final follow-up. The mean follow-up was 11.8 (range, 10-12.7) years. Six patients were lost to follow-up. All functional scores showed a significant improvement (P < .001) at the 5- and 10-year follow-up. The exception was the Tegner score, which
remained stable. The joint-space width was maintained from the preoperative period (1.9 1.2 mm) up to the 5-year
follow-up (1.3 1.5 mm, P ¼ .3) and decreased by the last evaluation (0.6 1.2 mm, P ¼ .001) at the last follow-up.
Two (9.5%) of 21 patients were converted to a total knee replacement during the study period. None of the other
patients needed revision surgery during the study period.
Conclusions: The polyurethane meniscal scaffold provides significant and stable pain relief over time and improved functional outcomes at a minimum of 10 years after surgery.
However, degenerative changes progressed in the treated compartment, with a joint-space narrowing over the 10-year period.
Level of evidence: Level IV, retrospective case series.
