Malahias Michael-Alexander, Kostretzis Lazaros, Megaloikonomos Panayiotis D, Cantiller Erwin-Brian, Chytas Dimitrios, Thermann Hajo, Becher Christoph
International Centre for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany.
Second Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Orthop Rev (Pavia). 2021 Jan 29;12(4):8872. doi: 10.4081/or.2020.8872. eCollection 2020 Dec 31.
This study was performed to determine whether Autologous Matrix-Induced Chondrogenesis (AMIC) is an effective and safe treatment option for patients with symptomatic Osteochondral defects of the Talus (OCTs) and to identify factors that influence the clinical outcome. A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers independently conducted the literature search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. The databases were queried using the terms "autologous" AND "matrix" AND "induced" AND "chondrogenesis." Thirteen studies were eligible for review. All studies that compared the preoperative and postoperative mean values of different clinical/functional scores showed significant clinical improvement. The final postoperative mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score ranged from 50.9 to 74.5. The included studies indicated that age and body mass index may have a detrimental impact on the postoperative outcome. A higher re-intervention rate is expected with the open technique, mainly because of hardware removal after malleolar osteotomy. This data analysis demonstrated that both arthroscopic and open AMIC procedures are effective and safe for the treatment of OCTs. Level IV, systematic review of therapeutic studies.
本研究旨在确定自体基质诱导软骨形成术(AMIC)对于有症状的距骨骨软骨损伤(OCT)患者是否是一种有效且安全的治疗选择,并确定影响临床结果的因素。根据系统评价和Meta分析的首选报告项目(PRISMA)指南对文献进行了系统评价。三名评价者独立使用MEDLINE/PubMed数据库和Cochrane系统评价数据库进行文献检索。使用“自体”“基质”“诱导”“软骨形成”等术语查询数据库。有13项研究符合评价标准。所有比较不同临床/功能评分术前和术后平均值的研究均显示出显著的临床改善。术后最终的平均磁共振软骨修复组织观察(MOCART)评分为50.9至74.5。纳入的研究表明,年龄和体重指数可能对术后结果产生不利影响。开放技术的再次干预率较高,主要是因为踝关节截骨术后需要取出内固定物。该数据分析表明,关节镜下和开放AMIC手术治疗OCT均有效且安全。四级,治疗性研究的系统评价。