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Autologous Matrix-Induced Chondrogenesis (Amic) For Isolated Retropatellar Cartilage Lesions: Outcome After A Follow-Up Of Minimum Two Years


Manuel Waltenspül, MD
SWITZERLAND

Autologous Matrix-Induced Chondrogenesis (Amic) For Isolated Retropatellar Cartilage Lesions: Outcome After A Follow-Up Of Minimum Two Years

Manuel Waltenspül, MD, SWITZERLAND Cyrill Suter, MD, SWITZERLAND Jakob Ackermann, MD, SWITZERLAND Nathalie Kühne, SN, SWITZERLAND Sandro Fucentese, Prof MD, SWITZERLAND

Balgrist University Hospital, Zürich, 8008, SWITZERLAND

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Knee Patellofemoral

Anatomic Structure

Cartilage

Diagnosis / Condition

Trauma

Treatment / Technique

Repair / Reconstruction Autograft Stem Cell Therapy

Patient Populations

Pediatric / Adolescent

Diagnosis Method

MRI

Sports Medicine

Sport Specific Injuries Biomechanics

Cartilage

Cartilage Treatment Cartilage Injuries

Patellofemoral

Acute Patella Dislocation Recurrent Subluxation and Dislocation Patellofemoral Osteoarthritis

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Summary: AMIC for retropatellar cartilage lesions in combination with concomitant corrective surgery for patellar instability results in low failure rate with satisfactory clinical outcome

Purpose

To evaluate autologous matrix-induced chondrogenesis (AMIC) for isolated focal retropatellar cartilage lesions and the influence of patellofemoral (PF) anatomy on clinical outcomes at a minimum of 2-year follow-up.

Methods

Twenty-nine consecutive patients (31 knees) that underwent retropatellar AMIC with a mean age of 27.9 +/- 11.0 years were evaluated at a follow-up averaging 4.1 +/- 1.9 (range, 2 to 8) years. Patient factors, lesion morphology and patient-reported outcome measures including KOOS, Tegner, Kujula score and VAS score were collected. PF anatomy was assessed on pre- and postoperative imaging, and subsequently correlated to outcome scores and failure to determine risk factors for poor outcome.

Results

At final follow-up, the AMIC graft failed in 4 cases (12.9%) at a mean follow-up of 21 +/- 14.1 months. Patients with failed grafts had a significantly smaller patellar and Laurins' PF angle than patients whose graft did not fail (p=0.008 and p=0.004, respectively). Concomitant corrective surgery for patellar instability was performed in 29 knees (93.5%). Grafts that did not fail presented with an average Kujala score of 71.3 +/-16.9, KOOS of 68.7 and Tegner scores of 4.2 +/- 1.8. The patellar angle was significantly associated with the patient’s satisfaction level (r=0.615; p<0.001).

Conclusion

AMIC for retropatellar cartilage lesions in combination with concomitant corrective surgery for patellar instability results in low failure rate with satisfactory clinical outcome and patient satisfaction of almost 80% at mid-term follow-up. Smaller patellar and Laurins' PF angle are associated with less favorable outcome.

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