Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France.
Hôpital d'instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France.
Orthop Traumatol Surg Res. 2024 Feb;110(1):103774. doi: 10.1016/j.otsr.2023.103774. Epub 2023 Nov 24.
Osteochondral defects of the knee due to trauma or osteochondritis are associated with osteoarthritis in the medium term. Defects 2 to 8cm in size can be managed by autologous matrix-induced chondrogenesis (AMIC®), in which sub-chondral micro-fractures are created within the lesion and the defect is then covered by a matrix of type I and type III collagen to induce de novo cartilage formation. Although promising outcomes have been observed in small single-centre cohorts, the medium-term clinical and radiological effectiveness of AMIC® remains to be demonstrated in larger populations. The objective of this study was to evaluate outcomes of patients at least 2 years after AMIC® for knee osteochondral defects.
AMIC® is associated with clinical and radiological improvements after at least 2 years.
This multicentre (16 centres), multisurgeon (18 senior orthopaedic surgeons), retrospective study included consecutive patients who underwent AMIC® with Chondro-Gide® membrane implantation between September 2011 and January 2020. The 36-item Short Form quality-of-life (SF-36) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) score were determined before the procedure and during follow-up. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was assessed by magnetic resonance imaging 2 years after the procedure.
In total, 101 patients aged 12 to 60 years were included. Mean follow-up was 30 months. Mean defect size was 3.44cm (range, 2-8cm). Significant improvements were documented in the SF-36 score, KOOS, and IKDC score. The mean MOCART score at 2 years was 75% (range, 20-100).
The AMIC® procedure was associated with significant improvements at 2.5 years in patients treated for knee osteochondral defects measuring 2 to 8cm. This method seems to provide similar outcomes to those of other available methods with the advantages of single-step surgery and elimination of osteochondral graft donor-site complications.
IV, retrospective observational cohort study.
由于创伤或骨软骨炎导致的膝关节骨软骨缺损与中期的骨关节炎有关。大小为 2 至 8cm 的缺损可以通过自体基质诱导软骨生成术（AMIC®）来治疗，其中在病变部位内创建亚软骨微骨折，然后用 I 型和 III 型胶原的基质覆盖该缺损以诱导新的软骨形成。尽管在小的单中心队列中观察到了有希望的结果，但 AMIC® 在更大人群中的中期临床和影像学效果仍有待证明。本研究的目的是评估接受 AMIC®治疗的膝关节骨软骨缺损患者至少 2 年后的结果。
AMIC®至少 2 年后与临床和影像学改善相关。
这是一项多中心（16 个中心）、多外科医生（18 位资深骨科医生）、回顾性研究，纳入了 2011 年 9 月至 2020 年 1 月期间接受 AMIC®联合软骨-Gide®膜植入术的连续患者。在手术前和随访期间确定了 36 项简明健康调查问卷（SF-36）评分、膝关节损伤和骨关节炎结果评分（KOOS）和国际膝关节文献委员会（IKDC）评分。术后 2 年通过磁共振成像评估磁共振软骨修复组织观察评分（MOCART）。
共纳入了 101 名 12 至 60 岁的患者。平均随访时间为 30 个月。平均缺损大小为 3.44cm（范围，2-8cm）。SF-36 评分、KOOS 和 IKDC 评分均有显著改善。术后 2 年的平均 MOCART 评分为 75%（范围，20-100）。
对于大小为 2 至 8cm 的膝关节骨软骨缺损患者，AMIC® 手术在 2.5 年内与显著改善相关。该方法似乎提供了与其他可用方法相似的结果，具有单步手术的优势，并消除了骨软骨移植物供体部位并发症。
IV，回顾性观察队列研究。
