Hi Owen,

What happened to your meniscus? A novel, polyurethane Actifit scaffold was designed to fulfill an unmet clinical need in the treatment of patients with painful irreparable partial meniscal defects. Actifit received its CE Mark in 2008 and it has been implanted for more than 900 patients across Europe. On the other hand Actifit shows promising early results in 2-year clinical stydy but require long-term studies too. I would visit mr. Verdonk in Gent and ask his opinion before Actifit surgery. Verdonk has done numerous Actifit surgeries and I believe he's most experienced in treatment of meniscus.

Here's one patient story and Here's another. Here's some common discussion about Actifit scaffold.

Good luck.

Hi all,
I was recently inspired by this forum to venture to obtain the Actift knee implant, after injuring my knee last year, and rendering it almost useless.
I wanted to help provide information to anyone in a similar situation to myself and this is my story so far....
After a lifetime of being super-fit, at 44 years of age, and absolutely no health problems whatsoever, I slipped on a cable, while turning quickly, and felt a pop in my knee.
Initially, I thought it was just a sprain, but after 6 wks of limping about with a locking knee, I went to my GP, he tested positive Mcmurrays, and sent me to hospital. I was apparently 'lucky' because the surgery was empty, and they carried out a partial menisectomy on the same day, without first doing an MRI.
After 3 months of excruciating physiotherapy, my knee function had declined to the point where I couldn't walk on it at all, so with my insistence I was eventually referred for an MRI.
3 months later, the MRI revealed that my symptoms were due to 60% of my entire meniscus had sheared off, and needed removing. I went onto the waiting list for surgery, and waited for months, before I decided that going private was the only option for me.
I paid privately for the partial menisectomy to remove 60 percent of my medial meniscus, and following this surgery, I was told that my articular cartilage had been damaged (both Femur and patellar), and that damage had probably been incurred while trying to use the knee with a broken meniscus.
I nevertheless, optimistically awaited by recovery. It was n't long before I realised that the symptoms I was having were still almost exactly the same ie burning pain, joint laxity, catching.
I'd read about the Actifit meniscal  implant, and also the premature wear that the articular cartilage undergoes following menisectomy and decided to endeavour to obtain one.
I contacted Prof Peter Verdonk at the Ghent University Hospital in Belgium, and he arranged anr MRI, and consultation for me the following week. He determined that the Actifit meniscal implant was suitable for me because I was within the age range, I had an intact meniscal rim, and posterior and anterior meniscal horns, and in otherwise good health.
I had the Actifit meniscal implant successfully fitted, the following morning at a cost of £6000. The four days following the surgery, were quite painful, more so than the menisectomies that I'd had before, but after all, the surgery was a bit more intrusive. I'd had 2 internal sutures attaching the meniscal implant ends made arthroscopically, and 3 internal sutures that had been made externally through a one inch incision to hold the middle part of the implant. The implant length that was needed was 38mm.
All in all, there 3 small incisions for the arthroscope, internal sutures, and implant insertion, and these were sutured as well. I was also pleased to learn that I'd also had bone marrow aspirated and inserted within the knee capsule for stem cell healing, and Im hopeful that this will repair the articular surfaces, and the ligament laxity. After the surgery, my leg was wrapped in bandages and put into a cork leg case, immobilised for 5 days. I've been given a 6 month physio instruction manual, and so far I'm up to week 3. Its non-weightbearing for a total of 4 weeks and 5 days since surgery. I have to wear the Donjoy OA adjuster unloader brace to limit the flexion during the day, and locked at night. In a couple of weeks, I can change the settings on the brace to transfer my bodyweight onto the lateral compartment while the medial side is recovering, and this will allow me to walk again (Please note these unloader braces are not cheap - about £500). I can't emphasise enough, how awkward it is having a non-weightbearing leg, and I'd advise anyone considering the Actifit  to have a couple of days trial to prepare anything that can be foreseen to help with this stage.
 Its too early to say whether the Actifit implant has worked or not, all I can say is that I can do the excercises without pain, and the wounds have healed.
 I have an MRI and review that is due in 6 weeks to see whether I'm one of the 80% that has a good healing response. I'll give updates, as and when , or if anyone has questions feel free to ask.

Hi Chris, Thanks for your interest. Its nearly 7 weeks since I received the Actift implant, and I am now at the part-weightbearing stage. I did have a minor setback, in that the Donjoy OA Adjuster unloader brace that I'd ordered from the States arrived, only to discover that they'd sent the wrong leg, and they wouldn't exchange it at Donjoy UK. I therefore returned it and ordered the Bledsoe Thruster unloader brace instead. All this delayed my walking rehab for 2 weeks, and caused a bit of panic.
The good news is that my ROM is now between 5 degrees extension to about 80 degrees flexion. I'm meant to be aiming for 0 to 90 degrees and I think I'll be there within a week. It was really strange when I started walking while part-weightbearing because my foot has become deprogrammed from the pressure of walking and I feel strange tingles in it, which I'm glad to say are lessening with time. I already feel a lot more stability in the knee joint than I've ever had since I injured it and I can only assume that the once loose implant is now integrated and providing support now. My right legs quads were already atrophied before the op, and they are virtually non-existent right now. The maximum pressure that I am allowed to apply this week is 30Kg and that will increase by 10Kg per week over the next month. Hopefully, my quads will begin to build up again soon. After about a month, I will hopefully be able to discard the crutches, and rely on the unloader brace for another one month thereafter. The next big event is on October 2nd, I will have an MRI to see how things are progressing. I'll be sure to keep you updated.

Good news! Yesterday, I returned to Belgium for an MRI scan and post op review to check on the status of my Actifit implant.
The verdict was as Prof Peter verdonk informed me "textbook perfect", the implant is ideally situated, no tears and with absolutely no gaps between it and my original meniscus.

He also checked my ROM and noted that there was a significant amount of scar tissue from one of the incisions just below my patella, that was preventing full movement. I've been instructed to do as much as I possibly can to increase flexion, else I could be restricted to 90 degrees or require surgical adjustment. I know that this is probably due to me being overprotective of the implant, and therefore being too careful with physio, but now I feel that I'm ready to work on it properly. In fact, I'd be perfectly happy to be able just to run and walk without pain. I've also been told to get rid of the crutches as soon as possible now, to encourage my quads to return to normal sizel.

Since being told that all is going exceptionally well, I have noticed a giant improvement in my knees strength and pain-free capabilities, and I can only put that down to the mental aspect. I seem to be on the vertical part of the improvement curve now. The next stage will be walking whilst full weight bearing, and I will be back to tell you all about it in about 3 weeks.

Well I'm glad to say that its been 2 weeks since I used crutches, and my ability to walk has improved to the point, where it is possible to walk for about 3 miles without pain, limping, or feeling any catching under the kneecap. Anything over that distance, results in niggling mild pain beneath my knee, and a similar mild pain within the medial/posterior  side of my knee. My ROM has improved to the point where I can rotate the pedals of a stationary bike, and over the past 2 weeks I have increased my range to 16Km, on a moderate setting (I could do more Kms if I wanted to). The bike is also great for improving my ROM, because I can lower the seat every 5Km or so, and the gradual strain applied to my warmed-up knee is far preferential to forcing it when cold. (ROM is currently about 0-115 degrees?)

There are still some hurdles to go yet: increasing my quads strength is high up on the list. I still can't climb stairs using my weak knee, without a slightly painful click under the kneecap and straining, so I'm waiting for the cycling to wear away the scar tissue, and strengthen my quads. Jogging or running are completely out of the question at the moment. (I'm really looking forward to it though!)
Overall, I'm feeling a lot more positive about my progress now. Its such a relief to be able to catch up on all of the jobs that have been building up over the past year. 

Great update!

Hi, It's still too soon to report any more progress since my last update, but in answer to your question about expectations, I think a lot depends on your current condition, regardless of other peoples experiences. There is one footballer who gives his experience, on Orteqs website, but that isn't an unbiased source of information.
Before I accidentally sheared my meniscus, I had 2 perfect knees, that at age 44 were as capable as they'd ever been in my life. After being almost incapacitated for about a year, superficially my hopes and aspirations became less and less, but deep down inside I long to be able to charge at 17mph over rough ground, like I used to. I'm taking everything one stage at a time, because I'd rather be able to walk normally for the next 20 years or so than revert to the state that I was in prior to the implant. I can say that at 6 months post op,I can do squats and lunges of a sort, but I'm aware that the strength in my right leg is about half that of my left, and I need to be careful. There is no way that I would currently consider squatting with an olympic bar across my neck, but I'm hopeful that that could happen in about 3 months time. Professor Peter Verdonk only asked two things from me after the operation:1) adhere to the rehabilitation procedure, and 2) emphatically no deep squats before 9 months. (he's based in Antwerp now, and has his own website.). In a nutshell, I believe that you're meant to make a full recovery after the Actifit implant, but for me personally, its too early to tell.