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Does AMIC® provide improvements at least two years after surgery for knee osteochondral lesions? A multicentre retrospective study of 101 patients - 26/01/24

Doi : 10.1016/j.otsr.2023.103774 
Matthieu Peras a, , Alexandre Caubère a, Camille Choufani a, Norbert Passuti b, Gilbert Versier c, Olivier Barbier a
a Hôpital d’instruction des Armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France 
b CHU de Nantes, 5, allée de l’île Gloriette, 44000 Nantes, France 
c Clinique Drouot-Lafitte, 20, rue Lafitte, 75009 Paris, France 

Corresponding author.

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Abstract

Background

Osteochondral defects of the knee due to trauma or osteochondritis are associated with osteoarthritis in the medium term. Defects 2 to 8cm2 in size can be managed by autologous matrix-induced chondrogenesis (AMIC®), in which sub-chondral micro-fractures are created within the lesion and the defect is then covered by a matrix of type I and type III collagen to induce de novo cartilage formation. Although promising outcomes have been observed in small single-centre cohorts, the medium-term clinical and radiological effectiveness of AMIC® remains to be demonstrated in larger populations. The objective of this study was to evaluate outcomes of patients at least 2 years after AMIC® for knee osteochondral defects.

Hypothesis

AMIC® is associated with clinical and radiological improvements after at least 2 years.

Material and method

This multicentre (16 centres), multisurgeon (18 senior orthopaedic surgeons), retrospective study included consecutive patients who underwent AMIC® with Chondro-Gide® membrane implantation between September 2011 and January 2020. The 36-item Short Form quality-of-life (SF-36) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) score were determined before the procedure and during follow-up. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was assessed by magnetic resonance imaging 2 years after the procedure.

Results

In total, 101 patients aged 12 to 60 years were included. Mean follow-up was 30 months. Mean defect size was 3.44cm2 (range, 2–8cm2). Significant improvements were documented in the SF-36 score, KOOS, and IKDC score. The mean MOCART score at 2 years was 75% (range, 20–100).

Discussion

The AMIC® procedure was associated with significant improvements at 2.5 years in patients treated for knee osteochondral defects measuring 2 to 8cm2. This method seems to provide similar outcomes to those of other available methods with the advantages of single-step surgery and elimination of osteochondral graft donor-site complications.

Level of evidence

IV, retrospective observational cohort study.

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Keywords : Knee, Cartilage, Sports surgery, Cartilage surgery, Joint


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© 2023  The Authors. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 110 - N° 1

Articolo 103774- febbraio 2024 Ritorno al numero
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