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<p>The implantation of a&#xa0;functional medial meniscus substitute may be indicated for medial-sided knee joint line pain due to loss or partial loss of the medial meniscus and limited damage to the articular cartilage with a&#xa0;straight leg axis in middle-aged patients (40–60&#xa0;years). After external radiological confirmation of the indication and size matching using magnetic resonance imaging (MRI) and after the surgeon has completed a&#xa0;training course, the artificial meniscus may be implanted. The operation includes arthroscopic removal of the medial meniscus remnants and preparation of the intercondylar notch with a&#xa0;bone rasp. After extending the medial portal to an about 6 cm medial arthrotomy, the self-centering implant can be inserted into the joint under valgus stress and transfer of the joint from flexion to extension. There is no fixation to the joint capsule. Rehabilitation includes functional treatment with partial weight-bearing for 1–3&#xa0;weeks. In two multicenter studies, variable results were found for the outcome with approximately 20% with documented complications. In a&#xa0;case series by the authors with 15&#xa0;patients (male/female 4/11: mean age ± SD [min–max]: 57.2 ± 7.2 [45–60], mean body mass index&#xa0;[± SD] 28.9 ± 3.6), a&#xa0;high revision rate of &gt; 60% was found in clinical follow-up after 18&#xa0;months. However, some patients had a&#xa0;favorable outcome and were free of symptoms with good joint function even for recreational sports for more than 3&#xa0;years. After a&#xa0;hearing and a&#xa0;negative vote for approval by the US Food and Drug Administration (FDA), the manufacturer withdrew the implant from the market worldwide and it is no longer available for clinical use.</p>

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Artifizieller Meniskusersatz – Indikation, Technik und Ergebnisse

  • 期刊论文

  • 发表日期：

    2025年5月30日

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  • Jürgen Höher,
  • Dale Swart-Stranzenbach,
  • Maurice Balke

摘要

The implantation of a functional medial meniscus substitute may be indicated for medial-sided knee joint line pain due to loss or partial loss of the medial meniscus and limited damage to the articular cartilage with a straight leg axis in middle-aged patients (40–60 years). After external radiological confirmation of the indication and size matching using magnetic resonance imaging (MRI) and after the surgeon has completed a training course, the artificial meniscus may be implanted. The operation includes arthroscopic removal of the medial meniscus remnants and preparation of the intercondylar notch with a bone rasp. After extending the medial portal to an about 6 cm medial arthrotomy, the self-centering implant can be inserted into the joint under valgus stress and transfer of the joint from flexion to extension. There is no fixation to the joint capsule. Rehabilitation includes functional treatment with partial weight-bearing for 1–3 weeks. In two multicenter studies, variable results were found for the outcome with approximately 20% with documented complications. In a case series by the authors with 15 patients (male/female 4/11: mean age ± SD [min–max]: 57.2 ± 7.2 [45–60], mean body mass index [± SD] 28.9 ± 3.6), a high revision rate of > 60% was found in clinical follow-up after 18 months. However, some patients had a favorable outcome and were free of symptoms with good joint function even for recreational sports for more than 3 years. After a hearing and a negative vote for approval by the US Food and Drug Administration (FDA), the manufacturer withdrew the implant from the market worldwide and it is no longer available for clinical use.