Fontana Andrea
Istituto Auxologico Italiano-Polo Chirurgico Capitanio, Milan, Italy.
Arthrosc Tech. 2012 Apr 21;1(1):e63-8. doi: 10.1016/j.eats.2012.02.003. Print 2012 Sep.
Microfracture is the standard of care for the treatment of small cartilage defects in the hip. Autologous matrix-induced chondrogenesis (AMIC) is a novel, 1-step approach that combines microfracture with a type I/III collagen matrix (Chondro-Gide; Geistlich Pharma AG, Wolhusen, Switzerland) to cover the microfractured defect area. The AMIC procedure has been successfully established for treating cartilage defects in the knee and talus, and we report, for the first time, its application in the hip. More importantly, at our center, we have developed a fully arthroscopic approach for the use of AMIC in the hip. Arthroscopic procedures are more desirable than open surgery because they are less invasive and hence reduce the risk of complications, such as infection or avascular necrosis of the femoral head, and allow for a shorter recovery time, resulting not only in lower overall treatment costs but also higher patient satisfaction. The arthroscopic AMIC procedure as described in this report, though surgically challenging, represents a viable, cost-effective treatment option for the repair of chondral lesions of the hip, especially when compared with autologous chondrocyte implantation.
微骨折术是治疗髋关节小面积软骨缺损的标准治疗方法。自体基质诱导软骨形成术(AMIC)是一种新颖的一步法,它将微骨折术与I/III型胶原基质(Chondro-Gide;盖氏制药股份公司,瑞士沃尔胡森)相结合,以覆盖微骨折缺损区域。AMIC手术已成功用于治疗膝关节和距骨的软骨缺损,我们首次报道其在髋关节中的应用。更重要的是,在我们中心,我们已开发出一种在髋关节中使用AMIC的全关节镜方法。关节镜手术比开放手术更可取,因为它侵入性较小,因此降低了并发症风险,如感染或股骨头缺血性坏死,并能缩短恢复时间,不仅降低了总体治疗成本,还提高了患者满意度。本报告中描述的关节镜AMIC手术虽然在手术上具有挑战性,但对于修复髋关节软骨损伤而言,是一种可行的、具有成本效益的治疗选择,尤其是与自体软骨细胞植入相比。