Shaikh Nafisa, Seah Matthew K T, Khan Wasim S
Nafisa Shaikh, SAS Facility, Faculty of Science, University of Technology, Sydney NSW 2007, Australia.
World J Orthop. 2017 Jul 18;8(7):588-601. doi: 10.5312/wjo.v8.i7.588.
To systematically review the results of studies looking at autologous matrix-induced chondrogenesis (AMIC) in humans.
A literature search was performed, adhering to the PRISMA guidelines, to review any studies using such techniques in humans. Our initial search retrieved 297 articles listed on MEDLINE, Google Scholar, CINHal and EMBASE. From these studies, 15 studies meeting the eligibility criteria were selected and formed the basis of our systematic review.
The study designs, surgical techniques and outcome measures varied between the studies. Although all studies reported improvements in patient outcome measures, this was not necessarily correlated with magnetic resonance imaging findings. Although there were many additional procedures performed, when AMIC was performed in isolation, the results tended to peak at 24 mo before declining.
Although short-term studies suggest improved patient reported outcomes with a variety of scaffolds, surgical techniques and rehabilitation regimes, the literature remains equivocal on whether the defect size and location, and patient factors affect the outcome. Patient benefit appears to be maintained in the short-to-medium term but more high level studies with extensive and robust validated outcome measures should be conducted to evaluate the medium- and long-term effect of the AMIC procedure.
系统评价观察人类自体基质诱导软骨形成(AMIC)的研究结果。
按照PRISMA指南进行文献检索,以回顾在人类中使用此类技术的任何研究。我们最初的检索在MEDLINE、谷歌学术、CINHal和EMBASE上检索到297篇文章。从这些研究中,选择了15项符合纳入标准的研究,并构成了我们系统评价的基础。
各研究之间的研究设计、手术技术和结局指标各不相同。尽管所有研究均报告患者结局指标有所改善,但这不一定与磁共振成像结果相关。尽管还进行了许多其他手术,但单独进行AMIC时,结果往往在24个月时达到峰值,然后下降。
尽管短期研究表明,使用各种支架、手术技术和康复方案可改善患者报告的结局,但关于缺损大小和位置以及患者因素是否影响结局,文献仍存在争议。患者获益似乎在短期至中期得以维持,但应开展更多具有广泛且经过充分验证的结局指标的高水平研究,以评估AMIC手术的中长期效果。