Jia Shyan Ong Jason, Fen Tan Sue, Kurien Thomas
Trauma & Orthopaedics Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trusts, UK.
Trauma & Orthopaedics Department, Kings Mill Hospital, Sherwood Forest Hospitals Foundation Trust, UK.
Knee. 2024 Dec;51:102-113. doi: 10.1016/j.knee.2024.08.003. Epub 2024 Sep 5.
Chondral defects of the knee can be identified in up to 60% of patients undergoing knee arthroscopy. The use of Autologous Matrix Induced Chondrogenesis (AMIC), which combines subchondral microfracture with a collagen membrane,has been increasingly used to treat these defects.
This review assesses the clinical, functional, and radiological outcomes of patients undergoing the AMIC procedure and reports any associated complications.
Studies with a minimum of 10 patients and fulfilled at least a 12-month follow up period with more than 70% follow up rate were included. Methodological quality was assessed using MINORS (Methodological Index for Non-Randomised Studies) criteria. The meta-analysis compared Lysholm, VAS (Visual Analog Scale), IKDC (International Knee Documentation Committee), KOOS (Knee Injury and Osteoarthritis Outcome Score) Pain, and Tegner clinical outcome measures at baseline and follow up.
18 studies (n = 490 patients) were included. The mean age was 35.2 [SD = 5.0] years and the mean defect size was 3.47 [SD = 0.96] cm. There was a clinically significant improvement in Lysholm, IKDC, and KOOS scores of 30.36 [95% CI (25.80, 34.93)], 34.05 [95% CI (4.16, 43.95)], and 30.63 [95% CI (24.78, 36.47)] respectively; and reduction in VAS pain score of -4.10 [95%CI (-4.50, -3.71) at follow up. Improvement in Tegner score at follow up was not statistically significant: 0.21 [95% CI (-0.88, 1.30)],(p > 0.05).
AMIC is a safe, effective, and reliable technique to treat knee chondral defects which can provide significant clinical, functional, and radiological improvements to patients.
在接受膝关节镜检查的患者中，高达60%可发现膝关节软骨损伤。自体基质诱导软骨形成（AMIC）技术将软骨下微骨折与胶原膜相结合，越来越多地用于治疗这些损伤。
本综述评估接受AMIC手术患者的临床、功能和放射学结果，并报告任何相关并发症。
纳入至少有10例患者且随访期至少12个月、随访率超过70%的研究。使用MINORS（非随机研究方法学指数）标准评估方法学质量。荟萃分析比较了基线和随访时的Lysholm、视觉模拟量表（VAS）、国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎疗效评分（KOOS）疼痛以及Tegner临床疗效指标。
纳入18项研究（n = 490例患者）。平均年龄为35.2岁[标准差=5.0]，平均损伤大小为3.47 cm[标准差=0.96]。Lysholm、IKDC和KOOS评分在临床上有显著改善，分别为30.36[95%置信区间（25.80，34.93）]、34.05[95%置信区间（4.16，43.95）]和30.63[95%置信区间（24.78，36.47）]；随访时VAS疼痛评分降低-4.10[95%置信区间（-4.50，-3.71）]。随访时Tegner评分的改善无统计学意义：0.21[95%置信区间（-0.88，1.30）]，（p>0.05）。
AMIC是一种治疗膝关节软骨损伤的安全、有效且可靠的技术，可为患者带来显著的临床、功能和放射学改善。
