Does AMIC® provide improvements at least two years after surgery for knee osteochondral lesions? A multicentre retrospective study of 101 patients.

Autor: Peras M; Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France. Electronic address: matthieu.peras@gmail.com., Caubère A; Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France., Choufani C; Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France., Passuti N; CHU de Nantes, 5, allée de l'île Gloriette, 44000 Nantes, France., Versier G; Clinique Drouot-Lafitte, 20, rue Lafitte, 75009 Paris, France., Barbier O; Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2024 Feb; Vol. 110 (1), pp. 103774. Date of Electronic Publication: 2023 Nov 24.
DOI: 10.1016/j.otsr.2023.103774
Abstrakt: Background: Osteochondral defects of the knee due to trauma or osteochondritis are associated with osteoarthritis in the medium term. Defects 2 to 8cm 2 in size can be managed by autologous matrix-induced chondrogenesis (AMIC®), in which sub-chondral micro-fractures are created within the lesion and the defect is then covered by a matrix of type I and type III collagen to induce de novo cartilage formation. Although promising outcomes have been observed in small single-centre cohorts, the medium-term clinical and radiological effectiveness of AMIC® remains to be demonstrated in larger populations. The objective of this study was to evaluate outcomes of patients at least 2 years after AMIC® for knee osteochondral defects.
Hypothesis: AMIC® is associated with clinical and radiological improvements after at least 2 years.
Material and Method: This multicentre (16 centres), multisurgeon (18 senior orthopaedic surgeons), retrospective study included consecutive patients who underwent AMIC® with Chondro-Gide® membrane implantation between September 2011 and January 2020. The 36-item Short Form quality-of-life (SF-36) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) score were determined before the procedure and during follow-up. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was assessed by magnetic resonance imaging 2 years after the procedure.
Results: In total, 101 patients aged 12 to 60 years were included. Mean follow-up was 30 months. Mean defect size was 3.44cm 2 (range, 2-8cm 2 ). Significant improvements were documented in the SF-36 score, KOOS, and IKDC score. The mean MOCART score at 2 years was 75% (range, 20-100).
Discussion: The AMIC® procedure was associated with significant improvements at 2.5 years in patients treated for knee osteochondral defects measuring 2 to 8cm 2 . This method seems to provide similar outcomes to those of other available methods with the advantages of single-step surgery and elimination of osteochondral graft donor-site complications.
Level of Evidence: IV, retrospective observational cohort study.
(Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: