Premiers résultats confirment l’efficacité et la sécurité des arthroscopiques de chondrogenèse autologue induite par matrice méthode la régénération du cartilage genou

Abstract

Objective To evaluate change over time of clinical scores and morphological MRI of cartilage appearance after full arthroscopic autologous matrix-induced chondrogenesis (AMIC) of the knee. Methods From a database of AMIC patients, all consecutive patients’ (age 13–63) treatment of knee cartilage lesions by autologous matrix-induced chondrogenesis (AMIC) from April 2010 to December 2011 were identified. All patients had been assessed preoperatively, and 6, 12 and 24 months postoperatively. Following information have been recorded: IKDC 2000 subjective score, IKDC 2000 clinical evaluation score and Lysholm score. All patients in the study had been assessed with MRI (morphological sequences) 6, 12 and 24 months postoperatively. Results Twenty-eight patients were identified for analysis with a median follow-up of 2 years (2,0–2,6). There were 23 patients treated with concomitant knee procedures such as ACL or PCL reconstruction, meniscal treatment and medial patelo-femoral ligament reconstruction. We had observed statistically significant improvement for Lysholm scale from 70,9 preoperatively to 86,5, 86,9 and 87,6, respectively 6, 12 and 24 months postoperatively, ( P = 0.001). We had also observed statistically significant improvement for IKDC subjective score assessment from 47,5 preoperatively to 69,8, 74,6 and 77,2, respectively 6, 12 and 24 months follow-up with P = 0.001. Tissue filling was present but often not complete or homogenous when evaluated with MRI. The cumulative modified MOCART (magnetic resonance observation of cartilage repair tissue) results had no correlations with both clinical or subjective scores results. Conclusions Full arthroscopic AMIC technique is safe and feasible for the treatment of symptomatic knee lesions and resulted in a progressive clinical improvement. The MRI findings of the repair tissue continue to evolve during the first two years after surgery. However, the subchondral lamina and bone changes are a concern. Patients with concomitant knee procedures can also benefit from this treatment option.