Clinical outcome after treatment of characterised cartilage defects by autologous matrix-induced chondrogenesis in active patients
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2016-03-31 |
Purpose: Evaluate autologous matrix-induced chondrogenesis (AMIC) treatment outcomes for characterised cartilage lesions. Evaluate untreated defects impact on clinical outcome. Methods: Fifteen patients (median age 30.7 years) actively engaged in recreational sports activities with symptomatic cartilage lesions of the knee were studied. Defects were characterised intraoperatively by count, size, grade and the area that received treatment. Lesions classified as grade III and IV by International Cartilage Repair Society (ICRS) were treated with AMIC or AMIC in conjunction with other cartilage repair techniques, whereas grade I and II lesions were left untreated. Two treatment exceptions were made. Patients from the Total group and four separate subgroups (Single; Multiple; Treated; Partly treated) were evaluated by ICRS and Tegner scores at the median follow-up of 4.5 years. Results: Total group patients were diagnosed with twenty-eight articular cartilage defects (1.9 per patient). The average defect size was 5.3 ± 2.2 cm2, of which 57% were classified as grade III and IV lesions. Patients from the Multiple subgroup had significantly greater diagnosed (6.9 ± 2.1 cm2, P ¼.012) and untreated (2.6 ± 2.6 cm2, P¼.038) lesions areas, when compared to the Single subgroup. Partly treated subgroup had a significantly larger area of untreated defect (3.6 ± 2.3 cm2, P¼.025), when compared to the Treated subgroup. The average ICRS preoperative values of the Total group and individual subgroups improved significantly at the follow-up. Significantly more patients retained their previous activity levels (P¼.026) and had a higher incremental ICRS score (P ¼.014) in the Single subgroup when compared to the Multiple subgroup. Total defect size diagnosed negatively correlated to ICRS incremental score (r ¼-.624, P¼.023) and had a tendency to postoperative ICRS score correlation (r ¼-.545, P ¼.054). Conclusions: AMI . [...].