Clinica Nostra Signora della Mercede, Via Tagliamento 25, 00198, Rome, Italy.
Accademia Biomedica Rigenerativa (ABRI), Via Misurina 56, 00135, Rome, Italy.
Int Orthop. 2024 Jan;48(1):267-277. doi: 10.1007/s00264-023-05921-8. Epub 2023 Sep 1.
To evaluate medium-term outcomes of knee cartilage defects repair by autologous matrix-induced chondrogenesis combined with simultaneous use of autologous adipose tissue graft and adipose tissue mesenchymal cells, defined as LIPO-AMIC technique.
The LIPO-AMIC technique has been used in ICRS degree III-IV knee defects. Eighteen patients have been prospectively evaluated during two and five years both clinically and by MRI.
Patients showed progressive significant improvement of all scores starting early at six months, and further increased values were noted till the last follow-up at 60 months. Mean subjective pre-operative IKDC score of 36.1 significantly increased to 86.4 at 24 months and to 87.2 at 60 months. Mean pre-operative Lysholm score of 44.4 reached 93.5 at two years and 93.5 at five years. MRI examination showed early subchondral lamina regrowth and progressive maturation of repair tissue and filling of defects. The mean total MOCART score showed that a significative improvement from two year follow-up (69.1 points) to last follow-up was 81.9 points (range, 30-100 points, SD 24). Complete filling of the defect at the level of the surrounding cartilage was found in 77.8%.
Adipose tissue can represent ideal source of MSCs since easiness of withdrawal and definite chondrogenic capacity. This study clearly demonstrated the LIPO-AMIC technique to be feasible for treatment of knee cartilage defects and to result in statistically significant progressive clinical, functional and pain improvement in all treated patients better than what reported for the AMIC standard technique, starting very early from the 6-month follow-up and maintaining the good clinical results more durably with stable results at mid-term follow-up.
评估自体基质诱导软骨再生联合同时使用自体脂肪组织移植物和脂肪组织间充质细胞（定义为 LIPO-AMIC 技术）修复膝关节软骨缺损的中期结果。
LIPO-AMIC 技术已用于 ICRS Ⅲ-Ⅳ级膝关节缺损。18 例患者前瞻性评估了 2 年和 5 年的临床和 MRI 结果。
患者在 6 个月时即开始出现所有评分的显著改善，且在最后一次随访（60 个月）时进一步增加。术前平均 IKDC 主观评分 36.1 显著增加至 24 个月时的 86.4，60 个月时的 87.2。术前平均 Lysholm 评分 44.4 在 2 年内达到 93.5，5 年内达到 93.5。MRI 检查显示早期软骨下板层再生和修复组织的逐渐成熟和缺损填充。平均总 MOCART 评分显示，从 2 年随访（69.1 分）到最后一次随访（81.9 分）有显著改善（范围：30-100 分，SD 24）。在 77.8%的患者中发现缺损在周围软骨水平完全填充。
脂肪组织可以作为 MSCs 的理想来源，因为其易于提取且具有明确的软骨生成能力。本研究清楚地表明，LIPO-AMIC 技术可用于治疗膝关节软骨缺损，并且与 AMIC 标准技术相比，所有治疗患者的临床、功能和疼痛均有显著且持续的改善，从 6 个月随访开始就非常明显，中期随访时仍保持良好的临床效果。
