Suivi à 10 ans des lésions cartilagineuses du genou traitées par induction autologue de chondrogénèse par matrice (AMIC)

Abstract

Purpose The authors reported a 10-year follow-up, retrospective review of patients treated with autologous matrix induced chondrogenesis (AMIC) for full-thickness chondral and osteochondral defects of the femoral condyle or patella combined with lower limb alignment or patellar tracking correction if indicated. Methods Thrity-three consecutive patients were treated surgically for chondral and osteochondral cartilage defects of the knee joint between 2003 and 2006. Patellar chondral lesions have been observed in 15 patients, whereas 8 patients presented a condylar location. 11 patients presented osteochondral lesions located in the condyles due to osteochondritis dissecans. Associated procedures, involving realignment of the patella, osteotomies around the knee, or cancellous bone grafting were performed when necessary. The mean size of the lesions was 2.80 cm2 and the mean patient age was 37 years. To evaluate the clinical outcomes, the Lysholm score and the VAS pain score have been measured, as well as the reoperation rate after the AMIC procedures with a mean follow-up of 9.3 years. Results An average ten-year follow-up was achieved in 24 patients who did not necessitate a reintervention procedure. Two patients underwent a total knee arthroplasty 9 and 10 years following the AMIC procedures. The follow-up rate of the cohort was 79 %, over the 10-year follow-up period. The 24 patients who did not require additional surgery showed significant improvement in both clinical functional and pain scores at 2 years of follow-up. This improvement remained stable at the 10-year follow-up with no significant change between the 2- and 10-year assessment outcomes. Conclusions AMIC is a safe procedure for the treatment of cartilage lesions in the knee joint that maintained a favorable outcome after an average of 10-years follow-up provided alignment of the lower limb or patellar tracking is correct. Such data is particularly encouraging for young adult patients who may benefit from a procedure that circumvents early arthroplasty.