Stable clinical long term results after AMIC in the aligned knee.


Journal

Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 02 02 2020
accepted: 02 08 2020
pubmed: 15 8 2020
medline: 26 11 2021
entrez: 15 8 2020
Statut: ppublish

Résumé

The aim of this study was to report a long-term follow-up of patients treated with autologous matrix-induced chondrogenesis (AMIC) for full-thickness chondral and osteochondral defects of the femoral condyle or patella combined with the correction of lower limb malalignment or patellar tracking if indicated. Thirty-three patients (thirty-four knees) were treated surgically for chondral and osteochondral cartilage defects of the knee joint. Regarding the origin of the lesion, patients were divided into three groups. Chondral lesions were observed in the patella (cP group) in fifteen patients, whereas eight patients demonstrated a femoral condylar location (cF group). Eleven patients presented with osteochondritis dissecans of the femur (ocF group). Associated procedures involving realignment of the patella, osteotomy around the knee, or cancellous bone grafting were performed when necessary. The mean size of the lesions was 2.8 ± 1.6 cm After an average of 9.3 ± 1 years, follow-up was completed in 79% of the patients. Two patients from the cohort received a total knee prosthesis. The primary outcome measures (Lysolm and VAS pain) at 9-year follow-up were 85 ± 13 for the Lysholm score and 1.9 ± 1.6 for the VAS score in the entire analyzed population. Compared to the preoperative values (Lysholm 56 ± 19, VAS 5.8 ± 2.4) and the 2-year results (Lysholm 85 ± 16, VAS 2.0 ± 2.1), there was significant improvement in the first 2 years after intervention and a stable course in the long-term observation. The same was observed in the cP and ocF subgroups, whereas patients of the cF group showed even further improvement. AMIC showed durable results in aligned knees. The favorable outcome was maintained after an average of 9 years when malalignment of the lower limb and patellar maltracking were corrected. Such data are particularly encouraging for young adult patients who may benefit from a procedure that circumvents early arthroplasty.

Identifiants

pubmed: 32794150
doi: 10.1007/s00402-020-03564-7
pii: 10.1007/s00402-020-03564-7
pmc: PMC8497318
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1845-1854

Informations de copyright

© 2020. The Author(s).

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Auteurs

Nadine Kaiser (N)

University Hospital of Berne, Freiburgstrasse 15, 3010, Bern, Switzerland. Nadine.kaiser@insel.ch.

Roland P Jakob (RP)

Kantonsspital Fribourg, Chemin Des Pensionnats 2-6, 1700, Fribourg, Switzerland.

Geert Pagenstert (G)

CLARAHOF Orthopaedics, Clarahofweg 19a, 4058, Basel, Switzerland.

Moritz Tannast (M)

Kantonsspital Fribourg, Chemin Des Pensionnats 2-6, 1700, Fribourg, Switzerland.

Daniel Petek (D)

Kantonsspital Fribourg, Chemin Des Pensionnats 2-6, 1700, Fribourg, Switzerland.

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