Debieux Pedro, Costa José Ricardo Dantas Moura, Weis Wesley Araujo, Astur Diego da Costa, Kaleka Camila Cohen, Cohen Moisés
Departamento de Cirurgia Ortopédica, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Departamento de Cirurgia Ortopédica, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2025 Jun 23;60(2):1-8. doi: 10.1055/s-0045-1809520. eCollection 2025 Apr.
To evaluate the clinical and functional outcomes of patients undergoing surgical treatment to repair focal chondral lesions in the patella and trochlea using the autologous matrix-induced chondrogenesis (AMIC) technique after a minimum follow-up of 2 years.
A total of 24 patients (25 knees) with a mean age of 39.6 ± 4.7 years underwent the patellofemoral AMIC technique and evaluation over a mean follow-up of 3.64 ± 0.65 years. We collected data on patient factors, lesion morphology, and patient-reported outcome measures, including the International Knee Documentation Committee (IKDC), Tegner, Kujala, Fulkerson, and Lysholm scores, as well as the Visual Analog Scale (VAS).
Male subjects accounted for 76% of the sample. The mean defect size of the chondral lesions was of 1.99 ± 0.36 cm . All defects were of grade IV according to the Outerbridge classification. At the last follow-up, patients showed the following mean increases in the scores: Kujala - from 61.9 to 87.9; IKDC -from 51.3 to 83.6; Lysholm -from 64.0 to 88.4; Tegner -from 4.04 to 5.12; Fulkerson -from 60.2 to 89.3; and VAS - from 5.6 to 1.24. All results were statistically significant ( < 0.05).
The AMIC technique is a safe, effective, and feasible method to treat symptomatic full-thickness chondral defects of the patellofemoral cartilage in properly-selected cases, and it resulted in clinical and functional improvement in all criteria under analysis.
评估采用自体基质诱导软骨形成（AMIC）技术手术修复髌骨和滑车局灶性软骨损伤的患者在至少随访2年后的临床和功能结局。
共有24例患者（25膝），平均年龄39.6±4.7岁，接受了髌股关节AMIC技术治疗，并进行了平均3.64±0.65年的随访评估。我们收集了患者因素、损伤形态以及患者报告的结局指标数据，包括国际膝关节文献委员会（IKDC）、泰格纳、库亚拉、富尔克森和利绍姆评分，以及视觉模拟量表（VAS）。
男性受试者占样本的76%。软骨损伤的平均缺损大小为1.99±0.36平方厘米。根据Outerbridge分类，所有缺损均为IV级。在最后一次随访时，患者的各项评分平均提高如下：库亚拉评分从61.9提高到87.9；IKDC评分从51.3提高到83.6；利绍姆评分从64.0提高到88.4；泰格纳评分从4.04提高到5.12；富尔克森评分从60.2提高到89.3；VAS评分从5.6提高到1.24。所有结果均具有统计学意义（P＜0.05）。
在适当选择的病例中，AMIC技术是治疗髌股关节软骨有症状的全层软骨缺损的一种安全、有效且可行的方法，并且在所有分析标准下均能带来临床和功能改善。
