Arthroscopy versus mini-arthrotomy approach for matrix-induced autologous chondrocyte implantation in the knee: a systematic review

Journal of Orthopaedics and Traumatology

Nicola Maffulli¹  Bryan J. M. van de Wall²  Matthias Knobe²  Filippo Spiezia³  Jörg Eschweiler⁴  Filippo Migliorini⁴  Markus Tingart⁴ 

[1] Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy;School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England;Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, E1 4DG, London, England;Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland;Department of Orthopaedic and Trauma Surgery, Ospedale San Carlo Potenza, Potenza, Italy;Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany;

关键词: Knee;    Chondral defect;    Autologous chondrocyte implantation;    mACI;    Arthroscopy;    Mini-arthrotomy;   

DOI  :  10.1186/s10195-021-00588-6

来源: Springer

【 摘 要 】

BackgroundMatrix-induced autologous chondrocyte implantation (mACI) can be performed in a full arthroscopic or mini-open fashion. A systematic review was conducted to investigate whether arthroscopy provides better surgical outcomes compared with the mini-open approach for mACI in the knee at midterm follow-up.MethodsThis systematic review was conducted following the PRISMA guidelines. The literature search was performed in May 2021. All the prospective studies reporting outcomes after mACI chondral defects of the knee were accessed. Only studies that clearly stated the surgical approach (arthroscopic or mini-open) were included. Only studies reporting a follow-up longer than 12 months were eligible. Studies reporting data from combined surgeries were not eligible, nor were those combining mACI with less committed cells (e.g., mesenchymal stem cells).ResultsSixteen studies were included, and 770 patients were retrieved: 421 in the arthroscopy group, 349 in the mini-open. The mean follow-up was 44.3 (12–60) months. No difference between the two groups was found in terms of mean duration of symptoms, age, body mass index (BMI), gender, defect size (P > 0.1). No difference was found in terms of Tegner Score (P = 0.3), Lysholm Score (P = 0.2), and International Knee Documentation Committee (IKDC) Score (P = 0.1). No difference was found in the rate of failures (P = 0.2) and revisions (P = 0.06).ConclusionArthroscopy and mini-arthrotomy approaches for mACI in knee achieve similar outcomes at midterm follow-up.Level of evidenceII, systematic review of prospective studies.

【 授权许可】

CC BY