Comment on Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-Up

We read with great interest the study by Akkaya et al[1] titled “Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-Up” in the “Journal of Knee Surgery.” The authors should be praised for their well-designed study and exciting results.

The Actifit polymer is a slowly degrading polymer with polycaprolactone and urethane segments. The degradation process is expected to take approximately 5 years.[2] Despite preclinical studies have proven the beneficial effects of the implant with regard to knee function, pain reduction, and restoration of activity levels and shown re-population of the implant through short-term biopsies, the persistence of magnetic resonance imaging abnormalities at 2 years[3] and also 5 years[2] [4] suggests that the meniscus has not fully matured. However, we found that the scaffold had the same shape and iso signal intensity as native meniscus.[1] We speculated that intra-articular bone marrow aspirate concentrate injection may be beneficial to tissue growth and maturation.[5] However, the author did not analyze and discuss it. Therefore, we are interested in the morphology and size of the scaffold as well as the signal intensity of the scaffold. If possible, we hope the author could provide more detailed data and explain this result. The data can therefore be used to help guide clinicians when faced with treatment decisions relating to a patient who has a symptomatic segmental medial meniscus lesion.

Publication History

Received: 21 September 2020

Accepted: 05 October 2020

Article published online:
09 November 2020

• References

• 1 Akkaya M, Şimşek ME, Gürsoy S, Çay N, Bozkurt M. Medial meniscus scaffold implantation in combination with concentrated bone marrow aspirate injection: minimum 3-year follow-up. J Knee Surg 2020; 33 (08) 838-846
• 2 Verdonk R, Verdonk P, Huysse W, Forsyth R, Heinrichs EL. Tissue ingrowth after implantation of a novel, biodegradable polyurethane scaffold for treatment of partial meniscal lesions. Am J Sports Med 2011; 39 (04) 774-782
• 3 Efe T, Getgood A, Schofer MD. et al. The safety and short-term efficacy of a novel polyurethane meniscal scaffold for the treatment of segmental medial meniscus deficiency. Knee Surg Sports Traumatol Arthrosc 2012; 20 (09) 1822-1830
• 4 Dhollander A, Verdonk P, Verdonk R. Treatment of painful, irreparable partial meniscal defects with a polyurethane scaffold: midterm clinical outcomes and survival analysis. Am J Sports Med 2016; 44 (10) 2615-2621
• 5 Koch M, Achatz FP, Lang S. et al. Tissue engineering of large full-size meniscus defects by a polyurethane scaffold: accelerated regeneration by mesenchymal stromal cells. Stem Cells Int 2018; 2018: 8207071