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A novel technique for treating cartilage defects in the hip: a fully arthroscopic approach to using autologous matrix-induced chondrogenesis.

ABSTRACT: Microfracture is the standard of care for the treatment of small cartilage defects in the hip. Autologous matrix-induced chondrogenesis (AMIC) is a novel, 1-step approach that combines microfracture with a type I/III collagen matrix (Chondro-Gide; Geistlich Pharma AG, Wolhusen, Switzerland) to cover the microfractured defect area. The AMIC procedure has been successfully established for treating cartilage defects in the knee and talus, and we report, for the first time, its application in the hip. More importantly, at our center, we have developed a fully arthroscopic approach for the use of AMIC in the hip. Arthroscopic procedures are more desirable than open surgery because they are less invasive and hence reduce the risk of complications, such as infection or avascular necrosis of the femoral head, and allow for a shorter recovery time, resulting not only in lower overall treatment costs but also higher patient satisfaction. The arthroscopic AMIC procedure as described in this report, though surgically challenging, represents a viable, cost-effective treatment option for the repair of chondral lesions of the hip, especially when compared with autologous chondrocyte implantation.

SUBMITTER: Fontana A

PROVIDER: S-EPMC3678655 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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A novel technique for treating cartilage defects in the hip: a fully arthroscopic approach to using autologous matrix-induced chondrogenesis.

Fontana Andrea A

Arthroscopy techniques 20120421 1

Microfracture is the standard of care for the treatment of small cartilage defects in the hip. Autologous matrix-induced chondrogenesis (AMIC) is a novel, 1-step approach that combines microfracture with a type I/III collagen matrix (Chondro-Gide; Geistlich Pharma AG, Wolhusen, Switzerland) to cover the microfractured defect area. The AMIC procedure has been successfully established for treating cartilage defects in the knee and talus, and we report, for the first time, its application in the hi ...[more]

PMID: 23766978

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Project description:Focal chondral defects of the knee are common and their management is challenging. This study investigated the efficacy and safety of Autologous Matrix-Induced Chondrogenesis (AMIC) for focal chondral defects of the knee. A systematic review and meta-analysis was conducted (according to the 2020 PRISMA statement) to investigate the efficacy of AMIC in improving symptoms and to compare AMIC versus microfracture (MFx). In January 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. No time constrain was used for the search. All the clinical trials investigating AMIC and/or those comparing AMIC versus MFx for focal chondral defects of the knee were accessed. Only studies published in peer reviewed journals were considered. Studies which investigated other locations of the defects rather than knee were not eligible, nor those reporting data form mixed locations. Studies which reported data on revision settings, as well as those investigating efficacy on kissing lesions or multiple locations, were not suitable. The mean difference (MD) and odd ratio (OR) effect measure were used for continuous and binary data, respectively. Data from 18 studies (548 patients) were retrieved with a mean follow-up of 39.9 ± 26.5 months. The mean defect size was 3.2 ± 1.0 cm2. The visual analogue scale (VAS) decreased of - 3.9/10 (95% confidence interval (CI) - 4.0874 to -3.7126), the Tegner Activity Scale increased of + 0.8/10 (95% CI 0.6595 to 0.9405). The Lysholm Knee Scoring System increased of + 28.9/100 (95% CI 26.8716 to 29.1284), as did the International Knee Documentation Committee (IKDC) + 33.6/100 (95% CI 32.5800 to 34.6200). At last follow-up no patient showed signs of hypertrophy. 4.3% (9 of 210) of patients underwent revision procedures. The rate of failure was 3.8% (9 of 236). Compared to MFx, AMIC demonstrated lower VAS score (MD: - 1.01; 95% CI - 1.97 to 0.05), greater IKDC (MD: 11.80; 95% CI 6.65 to 16.94), and lower rate of revision (OR: 0.16; 95% CI 0.06 to 0.44). AMIC is effective for focal chondral defects of the knee. Furthermore, AMIC evidenced greater IKDC, along with a lower value of VAS and rate of revision compared to MFx.

Dataset Information

A novel technique for treating cartilage defects in the hip: a fully arthroscopic approach to using autologous matrix-induced chondrogenesis.

Publications

A novel technique for treating cartilage defects in the hip: a fully arthroscopic approach to using autologous matrix-induced chondrogenesis.

Similar Datasets

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