Autologous matrix-induced chondrogenesis versus osteochondral autograft transfer system in patellar chondral lesions: a comparative study with a 2-year follow-up

Abstract

IntroductionFocal patellofemoral chondral lesions are clinically challenging, with unfavorable surgical results in the medium- and long-term; Although there is no golden standard technique to treat patellofemoral lesions, several patellar cartilage repair procedures are used with variable postoperative results. ObjectivesTo compare functional outcomes between patients who had undergone surgical treatment with osteochondral autograft transfer system (OATS) or autologous matrix-induced chondrogenesis (AMIC) for patellar chondral lesions preoperatively and after a 2-year follow-up. MethodsForty-six patients who underwent AMIC (n = 12) or OATS (n = 34), participated in this retrospective study. Outcome measures, including the Lysholm, Kujala, Fulkerson, and Tegner scores, were collected before surgery and 2 years after surgery. ResultsSex, age, laterality, or location of the patellar lesion were not significantly different between groups. The mean lesion size was greater in the AMIC group (2.18 cm2) than in the OATS group (1.13 cm2) (P < .001). There was no difference between groups in Lysholm, Fulkerson, and Kujala scores preoperatively, although the OATS group showed a more favorable Tegner score compared to the AMIC group (6.59 vs 3.45, P < .001). Postoperatively, the AMIC group had a higher mean Lysholm score than the OATS group, (88.3 vs 79.5, P = .025). Mean values of almost all clinical tests significantly increased at the end of the 2-year follow-up, in both groups, except for the Tegner score in the OATS group, which showed a mean reduction from 6.59 preoperatively to 5.47 postoperatively (P = .006). ConclusionOATS and AMIC are effective treatments for patellar chondral lesions, with sustainable results after a minimum follow-up period of 2 years. Patients who underwent AMIC had better clinical and functional outcomes than patients who underwent OATS for patellar chondral lesions during the follow-up period.