Migliorini, F, Eschweiler, J, Maffulli, N, Schenker, H, Baroncini, A, Tingart, M and Rath, B (2021) Autologous Matrix-Induced Chondrogenesis (AMIC) and Microfractures for Focal Chondral Defects of the Knee: A Medium-Term Comparative Study. Life (Basel), 11 (3). ISSN 2075-1729

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INTRODUCTION: The potential of autologous matrix-induced chondrogenesis (AMIC) to restore unipolar focal chondral defects of the knee is promising. However, the outcome compared to microfracturing (MFx) for certain defect sizes (2-3 cm2) is still uncertain. Therefore, the present study compared primary isolated AMIC versus MFx in a cohort of patients with borderline sized focal unipolar chondral defects of the knee at midterm follow-up. Methods: Patients with chondral defects of the knee who underwent AMIC or MFx were compared. An arthroscopic approach was used for MFx, and a minimally invasive parapatellar arthrotomy for AMIC. For those patients who underwent AMIC, a collagen membrane was used with fibrin glue. The patients answered independently: Visual Analogic Scale (VAS), Tegner Activity Scale, International Knee Documentation Committee (IKDC), and the Lysholm scores. Results: A total of 83 patients with a mean age of 30.2 and body mass index (BMI) of 26.9 kg/m2 were recruited. Of them, 33.7% (28 of 83) were women, and 55.4% (46 of 83 patients) had defects in the right knee. The mean length of symptoms before surgery was 43.3 months. The mean size of the defect was 2.7 cm2. The mean length of follow-up was 42.1 months. No difference was found in terms of symptoms and follow-up length, mean age and BMI, mean size of defect, sex, and side. The AMIC cohort reported greater IKCD (p > 0.0001), Lysholm (p = 0.002), VAS (p = 0.01), Tegner (p = 0.004) scores. The AMIC cohort reported lower rate of failure (p = 0.005) and revision surgery (p = 0.02). No difference was found in the rate of arthroplasty (p = 0.2). No delamination or hypertrophy were detected. Conclusion: AMIC demonstrated superiority over MFx for focal unipolar chondral defects of the knee. At approximately 40 months follow-up, the IKDC, Lysholm, and VAS scores were greater in the AMIC group. Patients treated with AMIC also demonstrated a higher level of sport activity, and lower rates of failure and revision surgeries.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via MDPI AG at https://doi.org/10.1136/bmj.n159 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: autologous matrix-induced chondrogenesis (AMIC), chondral defects, knee
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
R Medicine > RS Pharmacy and materia medica
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Related URLs:
Depositing User: Symplectic
Date Deposited: 19 Apr 2021 14:25
Last Modified: 25 Jun 2021 08:13
URI: https://eprints.keele.ac.uk/id/eprint/9385

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