Intra- and peri-meniscal polynucleotide injections for the treatment of symptomatic degenerative meniscus of the knee: 1-year findings from a prospective clinical trial.

UNLABELLED

OBJECTIVE: Degenerative meniscal lesions consist of an alteration of the meniscal structure, eventually leading to pain and dysfunction. In the absence of mechanical symptoms, meniscectomy should be considered the last resort. Polynucleotides represent a novel treatment option which have shown promising results in different fields, including knee osteoarthritis. Hence, this study aimed to evaluate the safety and efficacy of a cycle of intra- and peri-meniscal polynucleotide injections for the treatment of degenerative meniscus. MATERIALS AND METHODS: This prospective study included 30 patients aged 25-65 with degenerative meniscal tears confirmed by MRI. Eligible patients were treated with three intra- and peri-meniscal injections of polynucleotides, administered with a two-week time interval under ultrasound guidance. The primary outcome was improvement in the overall Knee Injury and Osteoarthritis Outcome Score (KOOS) by at least 10 points from baseline to 12-month follow-up. Secondary outcomes included Visual Analog Scale (VAS) for pain, the International Knee Documentation Committee (IKDC) score, and the Tegner Activity Scale. Safety was assessed through the monitoring of adverse events. RESULTS: Twenty-four patients completed the 12-month follow-up. KOOS scores showed a statistically significant improvement from a mean of 61.99 at baseline to 84.32 at 12 months [95% CI: (79.25, 89.4); p<0.001]. VAS mm scores also decreased significantly, from 62.68 at baseline to 20.63 at 12 months [95% CI, (12.84, 28.41), p<0.001]. Improvements in IKDC and Tegner scores were observed but plateaued after 6 months. No adverse events were reported throughout the entire study period. CONCLUSIONS: A cycle of three intra- and peri-meniscal poly-nucleotides injections is able to provide statistically significant improvements in clinical scores up to 1 year of follow-up in patients affected by symptomatic degenerative meniscus of the knee.

GRAPHICAL ABSTRACT

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