Abstract
Background: Knee cartilage defects can be retrieved in 60% of patients undergoing knee arthroscopy, especially in the patellofemoral joint. Different techniques have been proposed to treat patellar defects, although most of them are associated with short-term results. In this study Autologous Matrix Induced Chondrogenesis (AMIC), combining subchondral microfractures with a collagen membrane (type I and III collagen), was used in the treatment of isolated patellar cartilage defects. Methods: Twenty-four patients were enrolled in this retrospective study. Subjective-International Knee Documentation Committee (IKDC), Visual Analog Scale for Pain (VAS), and Kujala score were collected at 1, 3, 6, and 12 months after surgery, whereas the Tegner Activity Level Scale was determined preoperatively and at final follow-up (final-FU). The same postoperative management and rehabilitation protocol was adopted for all the patients. Results: Fourteen patients met the inclusion–exclusion criteria and were evaluated at a mean final-FU of 68.2 months (range 25.4–111.2). At 12 months, Kujala, IKDC, and VAS scores significantly increased in comparison to the preoperative assessment, whereas no statistically significant differences were reported between 12 months and final follow-up. Conclusion: This study demonstrated very good results throughout the follow-up, also in sports patients. The AMIC technique, together with an adequate rehabilitation protocol, can be considered as a reliable one-step alternative for the treatment of large isolated patellar cartilage defects.
Highlights
Cartilage defects are a common condition often leading to further joint degeneration into osteoarthritis that represents a considerable social and economic burden for society
Background: Knee cartilage defects can be retrieved in 60% of patients undergoing knee arthroscopy, especially in the patellofemoral joint
At 12 months, Kujala, International Knee Documentation Committee (IKDC), and Visual Analog Scale for Pain (VAS) scores significantly increased in comparison to the preoperative assessment, whereas no statistically significant differences were reported between 12 months and final follow-up
Summary
Cartilage defects are a common condition often leading to further joint degeneration into osteoarthritis that represents a considerable social and economic burden for society. Chondral lesions could be retrieved in up to 60% of knee arthroscopies and in 19% of them a grade IV chondromalacia could be identified, mainly located on the patellar cartilage [1]. In a retrospective study reporting 2931 patients with cartilage lesions, the patellar articular surface was involved in 37.5% of the patients [2]. These data were confirmed by a systematic review on the prevalence of chondral defects in athletes’ knees which reported that 37% of the defects were located on the patellofemoral joint (patella and trochlea) [3]. The AMIC technique, together with an adequate rehabilitation protocol, can be considered as a reliable one-step alternative for the treatment of large isolated patellar cartilage defects
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