Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial
Introduction: Evidence on the management of chondral defects of the patella arises from studies in which the patellofemoral joint was treated together with the femorotibial joint and primary and revision settings. Furthermore, the superiority of Autologous Matrix Induced Chondrogenesis (AMIC) over m...
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MDPI AG
2021-02-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/11/2/141 |
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| author | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Arne Driessen Björn Rath Markus Tingart Hanno Schenker |
| author_facet | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Arne Driessen Björn Rath Markus Tingart Hanno Schenker |
| author_sort | Filippo Migliorini |
| collection | DOAJ |
| description | Introduction: Evidence on the management of chondral defects of the patella arises from studies in which the patellofemoral joint was treated together with the femorotibial joint and primary and revision settings. Furthermore, the superiority of Autologous Matrix Induced Chondrogenesis (AMIC) over microfractures (MFx) for patellar chondral defects is uncertain. Therefore, the present study compared primary isolated AMIC versus MFx for focal unipolar chondral defects of the patellar facet joints at midterm follow-up. Methods: Patients undergoing AMIC or isolated MFx surgery for borderline-sized focal unipolar chondral defects of the patellar facet joints were followed at our institution. All surgeries were performed in the same fashion by experienced surgeons. A parapatellar arthrotomy was adopted in all surgeries. The outcomes of interest were: Visual Analogic Scale (VAS), Tegner Activity Scale, International Knee Documentation Committee (IKDC), and the Lysholm scores. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) was assessed by a blinded radiologist, who had not been involved in the clinical management of the patients. Results: 38 patients were enrolled in the present study: 27 underwent AMIC, and 11 MFx. The mean follow-up was 45.1 months. The mean age of the patients at baseline was 34.5 years. The mean size of the defect was 2.6 cm<sup>2</sup>. The MFx cohort experienced a shorter length of the hospitalization (<i>P</i> = 0.008). There was no difference in terms of follow-up and previous symptoms duration, mean age, sex, side, defect size, and BMI. At last follow-up, the AMIC cohort reported greater IKDC (<i>P</i> = 0.01), Lysholm (<i>P</i> = 0.009), and Tegner (<i>P</i> = 0.02), along with a low rate of failure (<i>P</i> = 0.02). VAS was lower in the AMIC group (<i>P</i> = 0.002). No difference was found in the MOCART score (<i>P</i> = 0.09), rates of revision (<i>P</i> = 0.06), and arthroplasty (<i>P</i> = 0.2). Conclusion: The AMIC procedure achieves greater IKDC and Lysholm score, and a significant reduction of the VAS score in the management of patellar chondral defects. The Tegner scale demonstrated greater activity after AMIC procedure. Finally, the AMIC group evidenced a lower rate of failure. Similarity was found on MOCART score, rates of revision, and arthroplasty between the two procedures. |
| first_indexed | 2024-03-09T00:55:11Z |
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| language | English |
| last_indexed | 2024-03-09T00:55:11Z |
| publishDate | 2021-02-01 |
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| series | Life |
| spelling | doaj.art-103b70a9d444458e949148bcef28bb112023-12-11T16:56:49ZengMDPI AGLife2075-17292021-02-0111214110.3390/life11020141Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical TrialFilippo Migliorini0Jörg Eschweiler1Nicola Maffulli2Arne Driessen3Björn Rath4Markus Tingart5Hanno Schenker6Department of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), ItalyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyDepartment of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, GermanyIntroduction: Evidence on the management of chondral defects of the patella arises from studies in which the patellofemoral joint was treated together with the femorotibial joint and primary and revision settings. Furthermore, the superiority of Autologous Matrix Induced Chondrogenesis (AMIC) over microfractures (MFx) for patellar chondral defects is uncertain. Therefore, the present study compared primary isolated AMIC versus MFx for focal unipolar chondral defects of the patellar facet joints at midterm follow-up. Methods: Patients undergoing AMIC or isolated MFx surgery for borderline-sized focal unipolar chondral defects of the patellar facet joints were followed at our institution. All surgeries were performed in the same fashion by experienced surgeons. A parapatellar arthrotomy was adopted in all surgeries. The outcomes of interest were: Visual Analogic Scale (VAS), Tegner Activity Scale, International Knee Documentation Committee (IKDC), and the Lysholm scores. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) was assessed by a blinded radiologist, who had not been involved in the clinical management of the patients. Results: 38 patients were enrolled in the present study: 27 underwent AMIC, and 11 MFx. The mean follow-up was 45.1 months. The mean age of the patients at baseline was 34.5 years. The mean size of the defect was 2.6 cm<sup>2</sup>. The MFx cohort experienced a shorter length of the hospitalization (<i>P</i> = 0.008). There was no difference in terms of follow-up and previous symptoms duration, mean age, sex, side, defect size, and BMI. At last follow-up, the AMIC cohort reported greater IKDC (<i>P</i> = 0.01), Lysholm (<i>P</i> = 0.009), and Tegner (<i>P</i> = 0.02), along with a low rate of failure (<i>P</i> = 0.02). VAS was lower in the AMIC group (<i>P</i> = 0.002). No difference was found in the MOCART score (<i>P</i> = 0.09), rates of revision (<i>P</i> = 0.06), and arthroplasty (<i>P</i> = 0.2). Conclusion: The AMIC procedure achieves greater IKDC and Lysholm score, and a significant reduction of the VAS score in the management of patellar chondral defects. The Tegner scale demonstrated greater activity after AMIC procedure. Finally, the AMIC group evidenced a lower rate of failure. Similarity was found on MOCART score, rates of revision, and arthroplasty between the two procedures.https://www.mdpi.com/2075-1729/11/2/141kneepatellaautologous matrix induced chondrogenesisAMICmicrofractureschondral defects |
| spellingShingle | Filippo Migliorini Jörg Eschweiler Nicola Maffulli Arne Driessen Björn Rath Markus Tingart Hanno Schenker Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial Life knee patella autologous matrix induced chondrogenesis AMIC microfractures chondral defects |
| title | Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial |
| title_full | Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial |
| title_fullStr | Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial |
| title_full_unstemmed | Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial |
| title_short | Management of Patellar Chondral Defects with Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures: A Four Years Follow-Up Clinical Trial |
| title_sort | management of patellar chondral defects with autologous matrix induced chondrogenesis amic compared to microfractures a four years follow up clinical trial |
| topic | knee patella autologous matrix induced chondrogenesis AMIC microfractures chondral defects |
| url | https://www.mdpi.com/2075-1729/11/2/141 |
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