Functional and magnetic resonance imaging outcome after polyurethane meniscal scaffold implantation following partial meniscectomy.

PURPOSE: Prevention of the knee osteoarthritis following meniscectomy is implantation of an allotransplant or an artificial meniscus. We present retrospective study of our early results of the treatment using polyurethane meniscal scaffold. METHODS: From 2016 to 2020, we implanted nine polyurethane scaffolds (Actifit) after partial meniscectomy, five males and four females, age 36 (16-47), BMI 26.7 (17.2-35.9) kg/m2. Functional status, activity, pain, and MRI were assessed. RESULTS: FU 20.8 (6-48.5) months, 35.2 (0-68) months from the meniscectomy to the implantation. The average implant length was 46.1 (35-60) mm, average number of sutures was 7.6 (5-10). Lysholm score before surgery was 61.7 (49-85), after the surgery 86.4 (62-95) with p 0.0045, Tegner activity score before meniscectomy was 5.8 (4-7), after 3.8 (2-5), and after the scaffold implantation 4.6 (3-7) with p 0.0488. Before surgery, VAS score was 3.1 (2-4), and after 7.7 (5-9) with p 0.0042. Pursuant to the Genovese classification, the last follow-up MRI showed a type 2 meniscal morphology in four cases and a type 3 in five cases. Seven patients had type 1 and two had type 2 signal intensity. On average, the absolute extrusion of a transplanted meniscus was 3.67 mm, and the relative extrusion was 0.58 mm. Extrusion progress was not detected. CONCLUSION: Significantly improved knee functionality, increased level of physical activity, and reduced pain. MRI analysis revealed the meniscal transplant morphology and volume loss, as well as its extrusion without progression.

The grading model for the assessment of the total amount of epidural fibrosis in postoperative lumbar spine.

PURPOSE: To present a new model derived from Ross's model for the assessment of the total amount of epidural fibrosis and to present inter- and intravariability study. METHODS: Two readers blinded to each other and blinded to their first and second reading retrospectively evaluated the magnetic resonance examinations in 32 postoperative spine surgery patients using this model. RESULTS: Paired and unpaired two-sided t tests showed no significant difference between the first and second reading, and interclass correlation coefficient revealed good interobserver reliability. CONCLUSION: The proposed model enables estimation of the amount of epidural fibrosis in postoperative lumbar spine and does not require any additional software or hardware. It is designed for multi-centered clinical studies where it is necessary to compare the values of epidural fibrosis between the tested and control group. The use of the proposed model is fast and practical and helps to avoid complications arising from image format, calibration and software, which are often encountered in multi-centered studies.