Clinical Outcomes of an All-Arthroscopic Technique for Single-Stage Autologous Matrix-Induced Chondrogenesis in the Treatment of Articular Cartilage Lesions of the Knee

Abstract

Purpose The purpose of this study was to determine the clinical efficacy of an all-arthroscopic approach to autologous matrix-induced chondrogenesis (AMIC) for patients with articular cartilage lesions of the knee joint. We hypothesize that an all-arthroscopic, single-stage AMIC using a hyaluron-based cell-free scaffold improves the postoperative clinical scores for patients with isolated articular cartilage lesions of the knee in the early follow-up period. Methods All patients with focal osteochondral lesions of the knee treated with AMIC at our institution from November 2013 to January 2018 were included for analysis. Demographic information, baseline clinical characteristics, perioperative imaging, and follow-up International Knee Documentation Committee (IKDC) scores at 6 and 24 months postoperatively were collected. One-way analysis of variance (ANOVA) with a Bonferroni correction was used to assess for improvement before and after surgery, with statistical significance defined as p < .05. Results A total of 22 patients met the inclusion criteria and were analyzed for this study. Articular cartilage lesions were most commonly found at the center of the medial and lateral femoral condyles. Statistically significant improvements in IKDC scores were seen at the 6- and 24-month follow-up periods ( p < .05). Conclusion An all-arthroscopic technique for single-stage autologous matrix-induced chondrogenesis demonstrates significant early clinical improvement for the treatment of articular cartilage lesions of the knee. Level of Evidence 4

Autologous Matrix-Induced Chondrogenesis (AMIC) for Focal Chondral Lesions of the Knee: A 2-Year Follow-Up of Clinical, Proprioceptive, and Isokinetic Evaluation

“…We found it very encouraging that the assessment of the knee joint function improved to a good level, indicating a rapid improvement in activity and only minor ailments in the operated knee joint. Indeed, Chen Chou et al observed an increase in the IKDC scores 6 months after AMIC surgery, but their results were not as high as in the present study [24]. The IKDC results presented in this study were very similar to those described by Gobbi [25] and higher than the results obtained by AMIC patients in Hoburg's study 12 months after the procedure [26].…”

Does the Choice of Acellular Scaffold and Augmentation With Bone Marrow Aspirate Concentrate Affect Short-term Outcomes in Cartilage Repair? A Systematic Review and Meta-analysis

“…All 3 patients who underwent revision cartilage repair procedures had received multilayered acellular scaffolds in the initial repair procedure. Bertho et al 1 and Chen Chou and Tjoen Lie 4 stated that none of the patients in either study required revision cartilage repair procedures within the specified follow-up duration. The need or lack of need for repeat arthroscopy was noted by 6 studies.…”

“…In summary, 9 studies originated from Italy, 2,3,7,9,19,20,38,43,52 6 from Germany, 17,18,23,32,42,53 4 from Poland, 39,41,46,47 3 from Switzerland, 27,31,51 2 from Turkey, 48,49 and 1 each from Argentina, 5 Belgium, 12 France, 1 Lithuania, 22 the Netherlands, 10 Norway, 16 and Singapore. 4 Two studies were multicentered, involving centers from Canada, Spain, and South Korea. 45,50 In total, 17 studies had a retrospective study design, 11 were prospective, and 5 were randomized controlled trials.…”

Rehabilitation of Soccer Players’ Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery—A Pilot Study

“…The inserted matrix functions as a biocompatible and temporary scaffold, concentrating mesenchymal stem cells and growth factors specifically at the site of the defect-rather than dispersing them throughout the joint. This targeted approach promotes localized cartilage repair and the regeneration process more effectively [22][23][24].…”