Partial meniscus substitution with a polyurethane scaffold does not improve outcome after an open-wedge high tibial osteotomy

The aim of the study was to determine whether medial meniscal substitution with a polyurethane scaffold (Actifit(A (R))) improves the outcome of medial meniscal-deficient varus knees undergoing open-wedge high tibial osteotomy. Sixty patients with symptomatic varus knees those who underwent open-wedge high tibial osteotomies were prospectively studied. In 30 patients, the medial meniscus was left with a defect larger than 25 mm (Group M). An Actifit(A (R)) device was implanted (Group A) in the remaining 30 patients. Patients were functionally evaluated with WOMET, IKDC and VAS. Patient satisfaction was graded from 0 (not satisfied) to 4 (very satisfied). Both groups were comparable preoperatively. They had similar follow-up periods (31.2 months; range 24-47.5; n.s.). WOMET improved a mean of 53.4 +/- A 8.4 and 42.4 +/- A 17.2 points in Groups M and A, respectively (p = 0.002). IKDC improved a mean of 56.7 +/- A 12 and 50.3 +/- A 15.6 points in Groups M and A, respectively (n.s.). VAS dropped 5.9 +/- A 2.1 and 4.7 +/- A 2.8 points in Groups M and A, respectively (p = 0.006). Patient satisfaction averaged 3.3 +/- A 0.8 and 3.3 +/- A 1 in Groups M and A, respectively (n.s.). Patients with symptomatic varus knees were treated with open-wedge high tibial osteotomies, and a meniscectomy was improved more at short-term follow-up in most of the evaluated functional scores than those patients with concomitant implantation of a medial Actifit(A (R)) implant. However, there was no difference in terms of patient satisfaction with the procedure. Based on the short-term functional results of this study, no data were provided to support medial meniscal substitution with a polyurethane scaffold when an open-wedge high tibial osteotomy is being performed. Prospective comparative study, Level II.