Periosteal Transplantation Combined with the Autologous Matrix-Induced Chondrogenesis (AMIC) Technique in Isolated Patellofemoral Osteoarthritis

Abstract

Objective:Isolated cases of osteoarthritis of the knee represent a major clinical problem. A particular challenge is a case in which both articular surfaces are affected. Such is the case with the isolated form of patellofemoral osteoarthritis. Studies that describe methods for treating such conditions are few, and the results are not too promising.Methods:In this article, we present one such case of isolated patellofemoral osteoarthritis in which we used a new approach combining periosteal transplantation on one side and the autologous matrix-induced chondrogenesis (AMIC) technique on the other side.Results:The patient has improved, measured by the Knee injury and Osteoarthritis Outcome Score (KOOS) from 48 preoperatively to 77 at 1 year postoperatively (mean improvement) and measured by the Lysholm score from 45 preoperatively to 90 at 1 year postoperatively.Conclusion:This original approach has shown promising results in this patient and could be tested in a larger group of patients with the same type of osteoarthritis in order to estimate its real clinical value.

Autologous Matrix-Induced Chondrogenesis: A Systematic Review of the Clinical Evidence

“…Of the 13 identified observational studies with defects solely treated by AMIC, 2 articles were reports of single cases 4,48 and 11 were case series comprising a total of 253 patients (Appendix Tables A1-A3, available online). § Of the 11 identified clinical articles about AMIC combined with other materials or surgical procedures, 4 articles were reports of single cases 14,40,55,57 and 7 were case series of a total of 335 patients.…”

“…The range of Lysholm score improved from 9-79 preoperatively to 27-100 within the first 2 years, declined to 25-69 between 2 and 5 years, and increased to 53-92 beyond 5 years. 4,14,25,32,47,48 The range of the MOCART score was 40-76 at the first postoperative year and 31-77 at the second postoperative year. 15,16,46 No long-term data regarding the KOOS and MOCART scores beyond the second postoperative year were available.…”

“…25 Other complications included joint stiffness (9/ 566), 32 increased pain (3/566), 1,34 joint catching (3/566), 15,16 joint impingement (1/566), 50 joint effusion (1/566), 25 joint instability (1/566), 40 hematoma (1/566), 32 muscle vein thrombosis (1/566), 25 and muscle hypotrophy (1/566). 48 Yet, 18 of 28 publications did not report on complications.…”

No outgrowth of chondrocytes from non-digested particulated articular cartilage embedded in commercially available fibrin matrix: an in vitro study

“…The initial inhibition of cell invasion and therefore new tissue formation that we have seen in our in vitro model have therefore probably no effect on the final clinical outcome. Indeed, the authors of this text have used routinely the fibrin matrix in our cartilage repair techniques and have seen neither poor defect fill nor poor clinical results that could be related to the use of the fibrin matrix [ 19 , 20 ].…”

Matrix-Augmented Bone Marrow Stimulation With a Polyglycolic Acid Membrane With Hyaluronan vs Microfracture in Local Cartilage Defects of the Femoral Condyles: A Multicenter Randomized Controlled Trial

“…38 Furthermore, the published studies differ by quite heterogeneous patient cohorts and operative procedures, such as arthroscopic 30 versus open surgical 38 and fixation of the implant by suture, glue, or pin, as well as by enhancing substrates, including platelet-rich plasma 9 or an additional periosteal transplantation. 32…”