Autologous Matrix-Induced Chondrogenesis for the Treatment of Hip Acetabular Chondral Lesions Demonstrates Improved Outcomes: A Systematic Review

Ronak J Mahatme; Michael S Lee; Scott Fong; Tom George; Nicholas J Pettinelli; Kian Kardestuncer; Stephen M Gillinov; Nancy Park; Serkan Surucu; Andrew E Jimenez

doi:10.1016/j.arthro.2024.04.028

Autologous Matrix-Induced Chondrogenesis for the Treatment of Hip Acetabular Chondral Lesions Demonstrates Improved Outcomes: A Systematic Review

Arthroscopy. 2024 May 10:S0749-8063(24)00334-7. doi: 10.1016/j.arthro.2024.04.028. Online ahead of print.

Authors

Affiliations

¹ University of Connecticut School of Medicine, Farmington, CT 06032.
² Medical College of Wisconsin, Milwaukee, WI 52336.
³ Case Western Reserve University School of Medicine, Cleveland, OH 44106.
⁴ Creighton University School of Medicine, Omaha, NE 68178.
⁵ Kansas City University College of Osteopathic, Kansas City, MO 64106.
⁶ Middlebury College, Middlebury, VT 05753.
⁷ Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06519.
⁸ Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06519. Electronic address: andrew.jimenez@yale.edu.

PMID: 38735412
DOI: 10.1016/j.arthro.2024.04.028

Abstract

Purpose: To systematically investigate the outcomes of patients who underwent autologous matrix-induced chondrogenesis (AMIC) during hip arthroscopy for the treatment of acetabular chondral lesions due to femoroacetabular impingement syndrome (FAIS).

Methods: PubMed and Cochrane were queried in June 2022 to conduct this systematic review using the following keywords: "femoracetabular impingement," "arthroscopy," "microfracture," and "autologous matrix-induced chondrogenesis." Articles were included if they reported on patient-reported outcomes of AMIC during hip arthroscopy to treat chondral lesions of the hip. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Each study was queried for demographics, lesion classification, surgical treatment, patient-reported outcome scores, revision arthroscopy, and conversion to THA. A qualitative sub-analysis was performed to compare patients undergoing AMIC to patients undergoing microfracture alone if included studies also assessed results of microfracture alone.

Results: Four studies met inclusion criteria and assessed 209 hips undergoing AMIC. The included studies consisted of 99 male and 110 female patients. Mean postoperative follow-up ranged from 1 to 8 years, and mean patient age ranged from 34.3 to 45 years. Three of the four included studies reported the modified Harris Hip Scores (mHHS) and all three of these studies reported statistically significant improvement in the mHHS at final follow-up (p<0.001) with mean preoperative values ranging from 44.5-62.8 and mean postoperative values ranging from 78.8-95.8. Two of the four studies compared patients treated with AMIC to microfracture alone. In these two studies, the AMIC groups reported 0 patients converting to THA while the microfracture alone groups reported a highly variable rate of conversion to THA (2% - 32.6%).

Conclusion: Patients who underwent hip arthroscopy and AMIC for the treatment of FAIS and acetabular chondral lesions demonstrated improved patient reported outcomes and low rates of secondary surgeries at short-term follow-up.

Keywords: autologous matrix-induced chondrogenesis; chondral lesions; hip arthroscopy.

Publication types

Review