title: All-Arthroscopic Autologous Matrix-Induced Chondrogenesis-Aided Repair of a Patellar Cartilage Defect Using Dry Arthroscopy and a Retraction System.
abstract: The technique of all-arthroscopic autologous matrix-induced chondrogenesis (AMIC)-aided repair of patellar cartilage lesions using a retraction system and dry arthroscopy has been recently described. We report the first clinical and radiological data at a short-term follow-up. Twelve patients underwent AMIC-aided cartilage repair for a patellar lesion. All steps of the procedure were performed arthroscopically, which include the use of an intra-articularly placed retraction plate for distraction of the patellofemoral joint and evacuation of saline solution for collagen matrix insertion and fixation. Clinical assessment performed before surgery and at a mean follow-up time of 38 months (range: 24-70) included the following scores: Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and visual analog scale (VAS). Magnetic resonance imaging was performed at the follow-up examination, including the magnetic resonance observation of cartilage repair tissue (MOCART) score. The mean KOOS and IKDC scores increased significantly (p< 0.01) from 50.3 and 37.4 points preoperatively to 90.1 and 79.4 postoperatively. The VAS score decreased from 7.8 to 2.3 points. Mean MOCART score at follow-up was 58.3 points. Cartilage repair of patellar lesions aided by a retraction system in a dry arthroscopy setup is a promising approach. Further studies are needed to evaluate this procedure and compare it to existing matrix implantation techniques. The level of evidence for the study is 4 (case series).
authors.affiliation: Biological Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland.
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Sadlik
authors.affiliation: Biological Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Puszkarz
authors.affiliation: Biological Joint Reconstruction Department, St Luke's Hospital, Bielsko-Biala, Poland.
authors.forename: Lidia
authors.initials: L
authors.lastname: Kosmalska
authors.affiliation: Orthopaedic and Trauma Department, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Wiewiorski
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002357:Cartilage Diseases / Q000473:pathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries; D020219:Chondrogenesis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000473:pathology; D011859:Radiography; D014182:Transplantation, Autologous; D055815:Young Adult