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：

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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。