A systematic review on Autologous Matrix Induced Chondrogenesis (AMIC) for chondral knee defects

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-09-05 DOI:10.1016/j.knee.2024.08.003

Jason Jia Shyan Ong , Sue Fen Tan , Thomas Kurien

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引用次数: 0

Abstract

Background

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.

Aims

This review assesses the clinical, functional, and radiological outcomes of patients undergoing the AMIC procedure and reports any associated complications.

Methods

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.

Results

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] cm². 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).

Conclusion

AMIC is a safe, effective, and reliable technique to treat knee chondral defects which can provide significant clinical, functional, and radiological improvements to patients.

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关于自体基质诱导软骨生成（AMIC）治疗膝关节软骨缺损的系统性综述。

背景：在接受膝关节镜检查的患者中，多达 60% 的人可发现膝关节软骨缺损。目的：本综述评估了接受自体基质诱导软骨生成术（AMIC）的患者的临床、功能和放射学结果，并报告了相关并发症：方法：纳入至少有 10 名患者、随访期至少 12 个月、随访率超过 70% 的研究。方法学质量采用 MINORS（非随机研究方法学指数）标准进行评估。荟萃分析比较了基线和随访时的 Lysholm、VAS（视觉模拟量表）、IKDC（国际膝关节文献委员会）、KOOS（膝关节损伤和骨关节炎结果评分）疼痛和 Tegner 临床结果指标：结果：共纳入 18 项研究（n = 490 名患者）。平均年龄为 35.2 [SD = 5.0]岁，平均缺损面积为 3.47 [SD = 0.96] 平方厘米。随访时，Lysholm、IKDC 和 KOOS 评分分别为 30.36 [95% CI (25.80, 34.93)]、34.05 [95% CI (4.16, 43.95)]和 30.63 [95% CI (24.78, 36.47)]，均有明显改善；VAS 疼痛评分降低了 -4.10 [95%CI (-4.50, -3.71)]。随访时 Tegner 评分的改善无统计学意义：0.21 [95%CI (-0.88, 1.30)]，（P > 0.05）：AMIC是一种安全、有效、可靠的治疗膝关节软骨缺损的技术，能显著改善患者的临床、功能和影像学状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.