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. 2021 Jun 16;22(1):23.
doi: 10.1186/s10195-021-00588-6.

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

Affiliations

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

Filippo Migliorini et al. J Orthop Traumatol. .

Abstract

Background: Matrix-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.

Methods: This 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).

Results: Sixteen 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).

Conclusion: Arthroscopy and mini-arthrotomy approaches for mACI in knee achieve similar outcomes at midterm follow-up.

Level of evidence: II, systematic review of prospective studies.

Keywords: Arthroscopy; Autologous chondrocyte implantation; Chondral defect; Knee; Mini-arthrotomy; mACI.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the literature search
Fig. 2
Fig. 2
Methodological quality assessment

References

    1. Migliorini F, Berton A, Salvatore G, Candela V, Khan W, Longo UG, et al. Autologous chondrocyte implantation and mesenchymal stem cells for the treatments of chondral defects of the knee—a systematic review. Curr Stem Cell Res Ther. 2020 doi: 10.2174/1574888X15666200221122834. - DOI - PubMed
    1. Kreuz PC, Steinwachs MR, Erggelet C, Krause SJ, Konrad G, Uhl M, et al. Results after microfracture of full-thickness chondral defects in different compartments in the knee. Osteoarthr Cartil. 2006;14:1119–1125. doi: 10.1016/j.joca.2006.05.003. - DOI - PubMed
    1. Scillia AJ, Aune KT, Andrachuk JS, Cain EL, Dugas JR, Fleisig GS, et al. Return to play after chondroplasty of the knee in National Football League athletes. Am J Sports Med. 2015;43:663–668. doi: 10.1177/0363546514562752. - DOI - PubMed
    1. Davila Castrodad IM, Mease SJ, Werheim E, McInerney VK, Scillia AJ. Arthroscopic chondral defect repair with extracellular matrix scaffold and bone marrow aspirate concentrate. Arthrosc Tech. 2020;9:e1241–e1247. doi: 10.1016/j.eats.2020.05.001. - DOI - PMC - PubMed
    1. Atala A, Irvine DJ, Moses M, Shaunak S. Wound healing versus regeneration: role of the tissue environment in regenerative medicine. MRS Bull. 2010 doi: 10.1557/mrs2010.528. - DOI - PMC - PubMed

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