{"title":"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。","authors":"Jason Jia Shyan Ong , Sue Fen Tan , Thomas Kurien","doi":"10.1016/j.knee.2024.08.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Aims</h3><p>This review assesses the clinical, functional, and radiological outcomes of patients undergoing the AMIC procedure and reports any associated complications.</p></div><div><h3>Methods</h3><p>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 <em>meta</em>-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.</p></div><div><h3>Results</h3><p>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<sup>2</sup>. 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).</p></div><div><h3>Conclusion</h3><p>AMIC is a safe, effective, and reliable technique to treat knee chondral defects which can provide significant clinical, functional, and radiological improvements to patients.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 102-113"},"PeriodicalIF":1.6000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0968016024001352/pdfft?md5=a4396559e6156642eb226e3d989fd3e5&pid=1-s2.0-S0968016024001352-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A systematic review on Autologous Matrix Induced Chondrogenesis (AMIC) for chondral knee defects\",\"authors\":\"Jason Jia Shyan Ong , Sue Fen Tan , Thomas Kurien\",\"doi\":\"10.1016/j.knee.2024.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Aims</h3><p>This review assesses the clinical, functional, and radiological outcomes of patients undergoing the AMIC procedure and reports any associated complications.</p></div><div><h3>Methods</h3><p>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 <em>meta</em>-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.</p></div><div><h3>Results</h3><p>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<sup>2</sup>. 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).</p></div><div><h3>Conclusion</h3><p>AMIC is a safe, effective, and reliable technique to treat knee chondral defects which can provide significant clinical, functional, and radiological improvements to patients.</p></div>\",\"PeriodicalId\":56110,\"journal\":{\"name\":\"Knee\",\"volume\":\"51 \",\"pages\":\"Pages 102-113\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0968016024001352/pdfft?md5=a4396559e6156642eb226e3d989fd3e5&pid=1-s2.0-S0968016024001352-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0968016024001352\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016024001352","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
A systematic review on Autologous Matrix Induced Chondrogenesis (AMIC) for chondral knee defects
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.
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.
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