Treatment of Focal Chondral Lesions in the Patellofemoral Joint with Collagen Membrane: Clinical and Functional Outcomes in a Two-Year Follow-Up

TL;DR

This study shows that using the AMIC technique to treat cartilage damage in the patellofemoral joint leads to significant clinical and functional improvements over two years.

Contribution

The study provides long-term clinical evidence for the effectiveness of the AMIC technique in treating patellofemoral chondral lesions.

Findings

Patients showed statistically significant improvements in multiple outcome scores after AMIC treatment.

All treated chondral defects were full-thickness (grade IV) and showed functional recovery.

The AMIC technique was found to be safe and effective for properly selected cases.

Abstract

To evaluate the clinical and functional outcomes of patients undergoing surgical treatment to repair focal chondral lesions in the patella and trochlea using the autologous matrix-induced chondrogenesis (AMIC) technique after a minimum follow-up of 2 years.

A total of 24 patients (25 knees) with a mean age of 39.6 ± 4.7 years underwent the patellofemoral AMIC technique and evaluation over a mean follow-up of 3.64 ± 0.65 years. We collected data on patient factors, lesion morphology, and patient-reported outcome measures, including the International Knee Documentation Committee (IKDC), Tegner, Kujala, Fulkerson, and Lysholm scores, as well as the Visual Analog Scale (VAS).

Male subjects accounted for 76% of the sample. The mean defect size of the chondral lesions was of 1.99 ± 0.36 cm
2
. All defects were of grade IV according to the Outerbridge classification. At the last follow-up, patients showed the following mean increases in the scores: Kujala – from 61.9 to 87.9; IKDC –from 51.3 to 83.6; Lysholm –from 64.0 to 88.4; Tegner –from 4.04 to 5.12; Fulkerson –from 60.2 to 89.3; and VAS – from 5.6 to 1.24. All results were statistically significant (
p
 < 0.05).

The AMIC technique is a safe, effective, and feasible method to treat symptomatic full-thickness chondral defects of the patellofemoral cartilage in properly-selected cases, and it resulted in clinical and functional improvement in all criteria under analysis.

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