Gille Justus, Reiss Ellen, Freitag Moritz, Schagemann Jan, Steinwachs Matthias, Piontek Tomasz, Reiss Eric
Department of Orthopaedic and Trauma Surgery, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
OrthoPraxis, Zofingen, Switzerland.
Orthop J Sports Med. 2021 Feb 26;9(2):2325967120981872. doi: 10.1177/2325967120981872. eCollection 2021 Feb.
Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects.
To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee.
Case series; Level of evidence, 4.
A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points.
The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes.
AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.
自体基质诱导软骨形成术(AMIC)是一种成熟的全层软骨缺损治疗方法。
评估AMIC治疗膝关节软骨损伤的长期临床疗效。
病例系列;证据等级,4级。
一个多中心前瞻性登记处记录了接受软骨缺损修复患者的人口统计学数据和结果。该研究共纳入131例患者。采用Lysholm评分、膝关节损伤和骨关节炎疗效评分(KOOS)以及疼痛视觉模拟量表(VAS)评分进行疗效分析。所有患者的平均年龄±标准差为36.6±11.7岁。平均体重为80.0±16.8kg,平均身高为176.3±7.9cm,平均缺损大小为3.3±1.8cm。缺损分类为Outerbridge III级或IV级。采用重复测量方差分析比较所有时间点的结果。
该队列患者的中位随访时间为4.56±2.92年。AMIC术后1至2年时所有评分均有显著改善(P<0.001),术后7年时仍保持改善值。所有患者术前Lysholm评分的平均值为46.9±19.6。在1年随访时,Lysholm评分平均值显著更高,在7年随访时保持良好结果。与术前数据相比,KOOS术后值也有显著改善。在7年随访期间,平均VAS显著降低。年龄、性别和缺损大小对结果无显著影响。
AMIC是治疗膝关节软骨缺损的有效方法,术后7年可获得可靠的良好效果。