Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee
| Autor: | Justus Gille, Piero Volpi, Eric Reiss, Laura de Girolamo, Alfredo Schiavone-Panni, Roland Jakob, Sven Scheffler, Martin Volz, Sven Anders, Matthias Steinwachs, Udo Wittmann |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Cartilage Articular Male Oncology medicine.medical_specialty Adolescent Fractures Stress Intra-Articular Fractures Arthroplasty Subchondral Biomedical Engineering Physical Therapy Sports Therapy and Rehabilitation Knee Injuries Transplantation Autologous Patellofemoral Joint Internal medicine medicine Humans Immunology and Allergy Aged Guided Tissue Regeneration business.industry Cartilage Middle Aged Chondrogenesis Autologous matrix-induced chondrogenesis Treatment Outcome medicine.anatomical_structure Patient Satisfaction Clinical evidence Meta-analysis Female Collagen business |
| Zdroj: | CARTILAGE. 13:42S-56S |
| ISSN: | 1947-6043 1947-6035 |
| DOI: | 10.1177/1947603519870846 |
| Popis: | Objective A systematic review and meta-analysis of Autologous Matrix-Induced Chondrogenesis (AMIC®) outcomes for grade III/IV chondral and osteochondral lesions of the knee treated with Chondro-Gide®. Design Studies with a minimum follow-up of 1 year providing clinical results of AMIC repair in the knee were included based on PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Methodological quality was assessed by the modified Coleman Methodology Score (mCMS). The meta-analysis was comparing pain VAS (Visual Analog Scale), Lysholm score, and IKDC score (International Knee Documentation Committee) between baseline and follow-up after 1 or 2 years and after >3 years. Results Twelve studies (375 patients) were included. The mCMS demonstrated a suboptimal study design (ranking between 52 and 80). The mean age was 36.2 years (14-70 years). The mean defect size was 4.24 cm2 (0.8-22 cm2). The results from the random effects model indicated a clinically significant ( P < 0.05) improvement of pain VAS from baseline to follow-up at year 1 to 2 of −4.02(confidence interval −4.37; −3.67), still significant after 3 years. Lysholm score at year 1 or 2 improved significantly and remained highly significant after 3 years. IKDC score showed highly significant improvement of 32.61 between 1 and 2 years versus baseline values maintained after 3 years. Conclusions The AMIC procedure significantly improved the clinical status and functional scoring versus preoperative values. Evidence was obtained in a non-selected patient population, corresponding to real-life treatment of knee chondral and osteochondral defects. The evidence is sufficient to recommend AMIC in this indication. |
| Databáze: | OpenAIRE |
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