Satisfactory Clinical results and Low failure rate of medial
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The aim of the study was to evaluate the long-term clinical results, reoperations, surgical failure and complications at a minimum of 20 year of follow-up of the first 8 medial CMI scaffolds implanted by a single surgeon during a pilot European Prospective study.

7 of the 8 patients were contacted. The Cincinnati Score, VAS, and Lysholm Score were all taken into consideration. At the most recent follow-up, 4 patients had magnetic resonance imaging (MRI) done. It was also looked at complications, reoperations, and failures.

--The average follow-up was 21.5±0.5 years. 1 patient underwent TKA after 13 years from CMI implantation; a 2nd patient underwent valgus high tibial osteotomy 8 years after the index surgery and another patient underwent anterior cruciate ligament hardware removal at 21 years of follow-up.

--At the final follow-up, 3 patients were rated as “Excellent”, 1 as “Good” and 2 as “Fair” according to the Lysholm score.

--The Cincinnati score and the VAS were substantially stable over time.

--The MRI showed a mild osteoarthritis progression in 3 out of 4 patients according to the Yulish score, and the CMI signal was similar to the mid-term follow-up revealing 3 cases of myxoid degeneration and 1 case of normal signal with reduced scaffold size.

To summarize, the medial CMI is a safe procedure with good clinical outcomes and a low failure rate even after a long period of follow-up. The correct sign, as well as correcting axial malalignment and resolving knee instability at the time of the index surgery, are all needed for this. On the other hand, even after meniscus replacement, mild osteoarthritis development is possible.