Arthroscopic and open approaches for autologous matrix-induced chondrogenesis repair of the knee have similar results: a meta-analysis

Tan, Chin Hong Ben; Huang, XinYao Oliver; Tay, Zhi Quan; Bin Abd Razak, Hamid Rahmatullah

doi:10.1016/j.jisako.2023.10.003

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…While some studies suggest a faster recovery with arthroscopy, no significant differences have been observed within the first two years of follow-up [40]. Tan et al reported similar outcomes between arthroscopic and mini-open approaches in a meta-analysis [41].…”

Section: Discussionmentioning

confidence: 99%

Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results

Allegra,

Picchi,

Ratano

et al. 2023

Healthcare

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The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) treated between 2018 and 2021 were retrospectively reviewed and subdivided into two groups based on age (Group A, age < 45 years; Group B, age > 45 years). A clinical evaluation was performed using the International Knee Documentation Committee (IKDC), Lysholm score and Visual Analogue Score (VAS). Cartilage regeneration was evaluated via magnetic resonance (1.5 Tesla) and classified according to a Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) scoring system. At a minimum follow-up of 2 years, Group A patients obtained greater instrumental results in comparison to group B: in fact, the MOCART score was statistically significantly correlated with IKDC (r = 0.223) (p < 0.001) exclusively in group A. Nevertheless, a significant improvement in clinical functionality was shown in Group B (p < 0.001), demonstrating that this technique is safe, reproducible and capable of offering satisfactory clinical results regardless of age.

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Section: Discussionmentioning

confidence: 99%

Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results

Allegra,

Picchi,

Ratano

et al. 2023

Healthcare

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show abstract

“…Research efforts have been invested to improve the microfracture approach, aiming at overcoming its limits by increasing the stability of the fibrin clot and possibly enhancing tissue quality and durability of the functional outcome [ 6 ]. In this light, several scaffolds have been developed based on different molecules, such as chitosan [ 18 , 42 , 49 ]. Chitosan, a deacetylated chitin derivative found in the exoskeletons of crustaceans and insects [ 36 ], is biocompatible, biodegradable and a suitable scaffold for the proliferation and differentiation of chondrocytes [ 9 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Chitosan‐based scaffold augmentation to microfractures: Stable results at mid‐term follow‐up in patients with patellar cartilage lesions

De Marziani,

Boffa,

Andriolo

et al. 2024

J. exp. orthop.

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PurposePatellar cartilage lesions are a frequent and challenging finding in orthopaedic clinical practice. This study aimed to evaluate a chitosan‐based scaffold's mid‐term clinical and imaging results patients with patellar cartilage lesions.MethodsThirteen patients (nine men, four women, 31.3 ± 12.7 years old) were clinically evaluated prospectively at baseline, 12, 24 and at a final minimum follow‐up of 60 months (80.2 ± 14.7) with International Knee Documentation Committee (IKDC) subjective, Knee Injury and Osteoarthritis Outcome Score and Tegner scores. A magnetic resonance analysis was performed at the last follow‐up using the Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) 2.0 score.ResultsAn overall significant clinical improvement in the scores was observed from baseline to all follow‐ups, with stable clinical results from 24 months to the mid‐term evaluation. The IKDC subjective score passed from 46.3 ± 20.0 at baseline to 70.1 ± 21.5 at the last follow‐up (p = 0.029). Symptoms' duration before surgery negatively correlated with the clinical improvement from baseline to the final follow‐up (p = 0.013) and sex influenced the improvement of activity level from the preoperative evaluation to the final follow‐up, with better results in men (p = 0.049). In line with the clinical findings, positive results were documented in terms of cartilage repair quality with a mean MOCART 2.0 score of 72.4 ± 12.5.ConclusionsOverall, the use of this chitosan‐based scaffold provided satisfactory results with a stable clinical improvement up to mid‐term follow‐up, which should be confirmed by further high‐level studies to be considered a suitable surgical option to treat patients affected by patellar cartilage lesions.Level of EvidenceLevel IV, prospective case series.

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Autologous matrix‐induced chondrogenesis provides better outcomes in comparison to autologous minced cartilage implantation in the repair of knee chondral defects

Behrendt,

Eggeling,

Lindner

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeIn symptomatic mid‐sized focal chondral defects, autologous matrix‐induced chondrogenesis (AMIC) and minced cartilage implantation (MCI) offer two versatile treatment options. This study aimed to conduct a matched‐patient analysis of patient‐reported outcome measures to compare these two surgical treatment methods for focal chondral defects.MethodsAt the first centre, patients underwent a single‐stage procedure in which autologous cartilage was hand‐minced, implanted into the defect and fixed with fibrin glue. At the second centre, patients underwent AMIC, which was fixed in place with fibrin glue. All patients were seen 2–4 years postoperatively. Postoperative outcomes were assessed using the visual analogue scale for pain (VAS), the Lysholm score and the five domains of the knee osteoarthritis outcome score (KOOS). Patients from each surgical centre were matched by age, sex, defect size and defect localisation.ResultsIn total, 48 patients from two surgical centres (24 from each site) were matched for sex, age (MCI 30.3 ± 14.9 years vs. AMIC 30.8 ± 13.7 years) and defect size (MCI 2.49 ± 1.5 cm2 vs. AMIC 2.65 ± 1.1 cm2). Significantly better scores in the AMIC cohort were noted for VAS (p = 0.004), Lysholm (p = 0.043) and the KOOS subscales for pain (p = 0.016) and quality of life (p = 0.036). There was a significantly greater proportion of positive responders for Lysholm in the AMIC group (92%) compared with the MCI group (64%).ConclusionsThe AMIC procedure delivers superior patient outcomes compared with hand‐minced autologous cartilage implantation. These are mid‐term outcomes, with follow‐up between 2 and 4 years.Level of EvidenceLevel III.

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Arthroscopic and open approaches for autologous matrix-induced chondrogenesis repair of the knee have similar results: a meta-analysis

Cited by 3 publications

References 33 publications

Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results

Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results

Chitosan‐based scaffold augmentation to microfractures: Stable results at mid‐term follow‐up in patients with patellar cartilage lesions

Autologous matrix‐induced chondrogenesis provides better outcomes in comparison to autologous minced cartilage implantation in the repair of knee chondral defects

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