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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-11-2021 | Orthopaedic Surgery

Stable clinical long term results after AMIC in the aligned knee

Authors: Nadine Kaiser, Roland P. Jakob, Geert Pagenstert, Moritz Tannast, Daniel Petek

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2021

Abstract

Introduction

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.

Methods

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 cm², and the mean patient age was 37.1 ± 11.9 years. To evaluate the clinical outcomes, the Lysholm score and the VAS pain score were imposed, as well as the reoperation rate.

Results

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.

Conclusions

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.

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Title: Stable clinical long term results after AMIC in the aligned knee
Authors: Nadine Kaiser
Roland P. Jakob
Geert Pagenstert
Moritz Tannast
Daniel Petek
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2021
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03564-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stable clinical long term results after AMIC in the aligned knee

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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