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Meniscal Substitutes

par Verdonk, René;Schurhoff, Matthias;Kyriakidis, Theofylaktos ;Dhollander, Aad;Verdonk, Peter
Référence Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Springer Science+Business Media, page (2285-2293)
Publication Publié, 2025-01

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Résumé :

Meniscal tears are some of the most frequently encountered knee injuries in orthopedic practice and their surgical management results in one of the highest procedure volumes in orthopedic surgery. Primary repair has been advocated by international consensus as imperative, however, partial meniscectomy and associated meniscal tissue loss remains a global challenge in patients, who develop symptoms from meniscal insuffiency. The risk of degenerative consequences remains and meniscus restoration constitutes a treatment goal for long-term knee health. Meniscal scaffolds have shown promising results with short-, mid-, and long-term benefits reported in a significant body of evidence. The use of synthetic or biologic scaffold widens the treatment spectrum within a meniscus-preservation algorithm and provides solutions for symptomatic mid-substance meniscus tissue loss with the goal to prevent or delay the need for future arthroplasty. Pain and other short- and long-term sequelae of irreparable meniscal tears remain a challenge for the orthopedic community, and there is a genuine need for an approach which will offer patients and surgeons with new and reproducible treatment options (Gilbert and Ashwood, Trauma 9:189, 2007). Orteq Ltd (London UK) developed a polyurethane scaffold for the treatment of irreparable, painful meniscus tears and meniscal tissue defects. It is available in the medial and lateral configurations. Criteria for use include an intact meniscal rim and sufficient tissue in the anterior and posterior horns to permit fixation of the scaffold. Other requirements include a well aligned and stable knee joint, an ICRS classification grade ≤3, a body mass index <35 kg/m[[sup]]2[[/sup]], and the absence of systemic disease or infection sequelae (Hardeman et al., Knee Surg Sports Traumatol Arthrosc 23:59-64, 2015).