Pedro Debieux , Marcos Vinicios Rodrigues dos Santos , Diego da Costa Astur , Seth Lawrence Sherman , Moises Cohen , Camila Cohen Kaleka
{"title":"自体基质诱导的软骨形成与自体骨软骨移植系统治疗髌骨软骨病变：一项2年随访的比较研究","authors":"Pedro Debieux , Marcos Vinicios Rodrigues dos Santos , Diego da Costa Astur , Seth Lawrence Sherman , Moises Cohen , Camila Cohen Kaleka","doi":"10.1016/j.jcjp.2024.100189","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Focal patellofemoral chondral lesions are clinically challenging, with unfavorable surgical results in the medium- and long-term; Although there is no golden standard technique to treat patellofemoral lesions, several patellar cartilage repair procedures are used with variable postoperative results.</div></div><div><h3>Objectives</h3><div>To compare functional outcomes between patients who had undergone surgical treatment with osteochondral autograft transfer system (OATS) or autologous matrix-induced chondrogenesis (AMIC) for patellar chondral lesions preoperatively and after a 2-year follow-up.</div></div><div><h3>Methods</h3><div>Forty-six patients who underwent AMIC (<em>n</em> = 12) or OATS (<em>n</em> = 34), participated in this retrospective study. Outcome measures, including the Lysholm, Kujala, Fulkerson, and Tegner scores, were collected before surgery and 2 years after surgery.</div></div><div><h3>Results</h3><div>Sex, age, laterality, or location of the patellar lesion were not significantly different between groups. The mean lesion size was greater in the AMIC group (2.18 cm<sup>2</sup>) than in the OATS group (1.13 cm<sup>2</sup>) (<em>P</em> < .001). There was no difference between groups in Lysholm, Fulkerson, and Kujala scores preoperatively, although the OATS group showed a more favorable Tegner score compared to the AMIC group (6.59 vs 3.45, <em>P</em> < .001). Postoperatively, the AMIC group had a higher mean Lysholm score than the OATS group, (88.3 vs 79.5, <em>P</em> = .025). Mean values of almost all clinical tests significantly increased at the end of the 2-year follow-up, in both groups, except for the Tegner score in the OATS group, which showed a mean reduction from 6.59 preoperatively to 5.47 postoperatively (<em>P</em> = .006).</div></div><div><h3>Conclusion</h3><div>OATS and AMIC are effective treatments for patellar chondral lesions, with sustainable results after a minimum follow-up period of 2 years. Patients who underwent AMIC had better clinical and functional outcomes than patients who underwent OATS for patellar chondral lesions during the follow-up period.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 1","pages":"Article 100189"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Autologous matrix-induced chondrogenesis versus osteochondral autograft transfer system in patellar chondral lesions: a comparative study with a 2-year follow-up\",\"authors\":\"Pedro Debieux , Marcos Vinicios Rodrigues dos Santos , Diego da Costa Astur , Seth Lawrence Sherman , Moises Cohen , Camila Cohen Kaleka\",\"doi\":\"10.1016/j.jcjp.2024.100189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Focal patellofemoral chondral lesions are clinically challenging, with unfavorable surgical results in the medium- and long-term; Although there is no golden standard technique to treat patellofemoral lesions, several patellar cartilage repair procedures are used with variable postoperative results.</div></div><div><h3>Objectives</h3><div>To compare functional outcomes between patients who had undergone surgical treatment with osteochondral autograft transfer system (OATS) or autologous matrix-induced chondrogenesis (AMIC) for patellar chondral lesions preoperatively and after a 2-year follow-up.</div></div><div><h3>Methods</h3><div>Forty-six patients who underwent AMIC (<em>n</em> = 12) or OATS (<em>n</em> = 34), participated in this retrospective study. Outcome measures, including the Lysholm, Kujala, Fulkerson, and Tegner scores, were collected before surgery and 2 years after surgery.</div></div><div><h3>Results</h3><div>Sex, age, laterality, or location of the patellar lesion were not significantly different between groups. The mean lesion size was greater in the AMIC group (2.18 cm<sup>2</sup>) than in the OATS group (1.13 cm<sup>2</sup>) (<em>P</em> < .001). There was no difference between groups in Lysholm, Fulkerson, and Kujala scores preoperatively, although the OATS group showed a more favorable Tegner score compared to the AMIC group (6.59 vs 3.45, <em>P</em> < .001). Postoperatively, the AMIC group had a higher mean Lysholm score than the OATS group, (88.3 vs 79.5, <em>P</em> = .025). Mean values of almost all clinical tests significantly increased at the end of the 2-year follow-up, in both groups, except for the Tegner score in the OATS group, which showed a mean reduction from 6.59 preoperatively to 5.47 postoperatively (<em>P</em> = .006).</div></div><div><h3>Conclusion</h3><div>OATS and AMIC are effective treatments for patellar chondral lesions, with sustainable results after a minimum follow-up period of 2 years. Patients who underwent AMIC had better clinical and functional outcomes than patients who underwent OATS for patellar chondral lesions during the follow-up period.</div></div>\",\"PeriodicalId\":100760,\"journal\":{\"name\":\"Journal of Cartilage & Joint Preservation\",\"volume\":\"5 1\",\"pages\":\"Article 100189\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cartilage & Joint Preservation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667254524000258\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cartilage & Joint Preservation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667254524000258","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
局灶性髌股软骨病变在临床上具有挑战性，中期和长期手术结果不利；虽然没有治疗髌骨股骨病变的黄金标准技术，但几种髌骨软骨修复手术的使用具有不同的术后结果。目的比较采用自体骨软骨移植系统（OATS）或自体基质诱导软骨形成（AMIC）治疗髌骨软骨病变患者术前和2年随访后的功能结局。方法回顾性研究46例接受了AMIC （n = 12）或OATS （n = 34）的患者。结果测量包括术前和术后2年的Lysholm、Kujala、Fulkerson和Tegner评分。结果两组间髌骨病变的性别、年龄、侧位、部位差异无统计学意义。AMIC组的平均病变大小（2.18 cm2）大于OATS组（1.13 cm2） (P <；措施)。两组术前Lysholm、Fulkerson和Kujala评分无差异，尽管与AMIC组相比，OATS组的Tegner评分更高(6.59 vs 3.45, P <；措施)。术后，AMIC组Lysholm平均评分高于OATS组（88.3 vs 79.5, P = 0.025）。在2年随访结束时，两组几乎所有临床试验的平均值均显著升高，但OATS组的Tegner评分从术前的6.59降至术后的5.47 （P = 0.006）。结论oats和AMIC是治疗髌骨软骨病变的有效方法，至少随访2年，效果持续。在随访期间，接受AMIC治疗的髌骨软骨病变患者的临床和功能预后优于接受OATS治疗的患者。
Autologous matrix-induced chondrogenesis versus osteochondral autograft transfer system in patellar chondral lesions: a comparative study with a 2-year follow-up
Introduction
Focal patellofemoral chondral lesions are clinically challenging, with unfavorable surgical results in the medium- and long-term; Although there is no golden standard technique to treat patellofemoral lesions, several patellar cartilage repair procedures are used with variable postoperative results.
Objectives
To compare functional outcomes between patients who had undergone surgical treatment with osteochondral autograft transfer system (OATS) or autologous matrix-induced chondrogenesis (AMIC) for patellar chondral lesions preoperatively and after a 2-year follow-up.
Methods
Forty-six patients who underwent AMIC (n = 12) or OATS (n = 34), participated in this retrospective study. Outcome measures, including the Lysholm, Kujala, Fulkerson, and Tegner scores, were collected before surgery and 2 years after surgery.
Results
Sex, age, laterality, or location of the patellar lesion were not significantly different between groups. The mean lesion size was greater in the AMIC group (2.18 cm2) than in the OATS group (1.13 cm2) (P < .001). There was no difference between groups in Lysholm, Fulkerson, and Kujala scores preoperatively, although the OATS group showed a more favorable Tegner score compared to the AMIC group (6.59 vs 3.45, P < .001). Postoperatively, the AMIC group had a higher mean Lysholm score than the OATS group, (88.3 vs 79.5, P = .025). Mean values of almost all clinical tests significantly increased at the end of the 2-year follow-up, in both groups, except for the Tegner score in the OATS group, which showed a mean reduction from 6.59 preoperatively to 5.47 postoperatively (P = .006).
Conclusion
OATS and AMIC are effective treatments for patellar chondral lesions, with sustainable results after a minimum follow-up period of 2 years. Patients who underwent AMIC had better clinical and functional outcomes than patients who underwent OATS for patellar chondral lesions during the follow-up period.
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