PURPOSE: This pilot study was designed to describe the technical details and to present the preliminary outcome of autologous matrix-induced chondrogenesis (AMIC) combined with platelet-rich plasma gel, the so called AMIC plus technique, for the treatment of patellar cartilage defects in the knee. METHODS: The AMIC plus technique was used for the treatment of (osteo) chondral patellar lesions in the knee. The surgical technique is extensively described. Five patients were clinically prospectively evaluated during 2 years. MRI data were analysed based on the original MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) and modified MOCART scoring system. RESULTS: A clinical improvement became apparent after 24 months of follow-up. Both MOCART scoring systems revealed no significant deterioration or improvement of the repair tissue between one and 2 years of follow-up. However, all cases showed subchondral lamina and bone changes. The formation of intralesional osteophytes was observed in 3 of the 5 patients during the 2 years of follow-up. CONCLUSIONS: AMIC plus is feasible for the treatment of symptomatic patellar cartilage defects and resulted in a clinical improvement in all patients. The favourable clinical outcome of the AMIC plus technique was not confirmed by the MRI findings. LEVEL OF EVIDENCE: IV.
PURPOSE: This pilot study was designed to describe the technical details and to present the preliminary outcome of autologous matrix-induced chondrogenesis (AMIC) combined with platelet-rich plasma gel, the so called AMIC plus technique, for the treatment of patellar cartilage defects in the knee. METHODS: The AMIC plus technique was used for the treatment of (osteo) chondral patellar lesions in the knee. The surgical technique is extensively described. Five patients were clinically prospectively evaluated during 2 years. MRI data were analysed based on the original MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) and modified MOCART scoring system. RESULTS: A clinical improvement became apparent after 24 months of follow-up. Both MOCART scoring systems revealed no significant deterioration or improvement of the repair tissue between one and 2 years of follow-up. However, all cases showed subchondral lamina and bone changes. The formation of intralesional osteophytes was observed in 3 of the 5 patients during the 2 years of follow-up. CONCLUSIONS: AMIC plus is feasible for the treatment of symptomatic patellar cartilage defects and resulted in a clinical improvement in all patients. The favourable clinical outcome of the AMIC plus technique was not confirmed by the MRI findings. LEVEL OF EVIDENCE: IV.
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