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Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee.
CARTILAGE ( IF 2.7 ) Pub Date : 2019-09-11 , DOI: 10.1177/1947603519870846
Matthias R Steinwachs 1 , Justus Gille 2 , Martin Volz 3 , Sven Anders 4 , Roland Jakob 5 , Laura De Girolamo 6 , Piero Volpi 7 , Alfredo Schiavone-Panni 8 , Sven Scheffler 9 , Eric Reiss 10 , Udo Wittmann 11
Affiliation  

OBJECTIVE A systematic review and meta-analysis of Autologous Matrix-Induced Chondrogenesis (AMIC®) outcomes for grade III/IV chondral and osteochondral lesions of the knee treated with Chondro-Gide®. DESIGN Studies with a minimum follow-up of 1 year providing clinical results of AMIC repair in the knee were included based on PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Methodological quality was assessed by the modified Coleman Methodology Score (mCMS). The meta-analysis was comparing pain VAS (Visual Analog Scale), Lysholm score, and IKDC score (International Knee Documentation Committee) between baseline and follow-up after 1 or 2 years and after >3 years. RESULTS Twelve studies (375 patients) were included. The mCMS demonstrated a suboptimal study design (ranking between 52 and 80). The mean age was 36.2 years (14-70 years). The mean defect size was 4.24 cm2 (0.8-22 cm2). The results from the random effects model indicated a clinically significant (P < 0.05) improvement of pain VAS from baseline to follow-up at year 1 to 2 of -4.02(confidence interval -4.37; -3.67), still significant after 3 years. Lysholm score at year 1 or 2 improved significantly and remained highly significant after 3 years. IKDC score showed highly significant improvement of 32.61 between 1 and 2 years versus baseline values maintained after 3 years. CONCLUSIONS The AMIC procedure significantly improved the clinical status and functional scoring versus preoperative values. Evidence was obtained in a non-selected patient population, corresponding to real-life treatment of knee chondral and osteochondral defects. The evidence is sufficient to recommend AMIC in this indication.

中文翻译:

膝关节自体基质诱导软骨形成临床证据的系统评价和荟萃分析。

目的 对使用 Chondro-Gide® 治疗的膝关节 III/IV 级软骨和骨软骨损伤的自体基质诱导软骨形成 (AMIC®) 结果进行系统回顾和荟萃分析。根据 PRISMA 指南(系统评价和 Meta 分析的首选报告项目),包括至少 1 年随访提供膝关节 AMIC 修复临床结果的设计研究。方法学质量通过改良的 Coleman Methodology Score (mCMS) 进行评估。该荟萃分析比较了基线和 1 或 2 年后以及 >3 年后随访之间的疼痛 VAS(视觉模拟量表)、Lysholm 评分和 IKDC 评分(国际膝关节文献委员会)。结果 纳入了 12 项研究(375 名患者)。mCMS 展示了一个次优的研究设计(排名在 52 到 80 之间)。平均年龄为 36.2 岁(14-70 岁)。平均缺陷尺寸为 4.24 cm2 (0.8-22 cm2)。随机效应模型的结果表明,从基线到第 1 年至第 2 年的随访,疼痛 VAS 的临床显着改善(P < 0.05)为 -4.02(置信区间 -4.37;-3.67),3 年后仍然显着。第 1 年或第 2 年的 Lysholm 评分显着改善,并在 3 年后保持高度显着性。与 3 年后维持的基线值相比,IKDC 评分在 1 至 2 年之间显示出 32.61 的显着改善。结论 与术前值相比,AMIC 程序显着改善了临床状态和功能评分。证据是在未选择的患者群体中获得的,对应于膝关节软骨和骨软骨缺损的现实治疗。
更新日期:2019-11-01
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