Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2017; 8(7): 588-601
Published online Jul 18, 2017. doi: 10.5312/wjo.v8.i7.588
Systematic review on the use of autologous matrix-induced chondrogenesis for the repair of articular cartilage defects in patients
Nafisa Shaikh, Matthew K T Seah, Wasim S Khan
Nafisa Shaikh, SAS Facility, Faculty of Science, University of Technology, Sydney NSW 2007, Australia
Matthew K T Seah, Department of Trauma and Orthopaedics, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom
Wasim S Khan, University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom
Author contributions: Khan WS designed the research; Shaikh N, Seah MKT and Khan WS performed the research; Shaikh N, Seah MKT and Khan WS analyzed the data; Shaikh N and Seah MKT wrote the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: Each author certifies that he has no commercial associations that might pose a conflict of interest in connection with the submitted article.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Matthew K T Seah, Department of Trauma and Orthopaedics, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. matt.seah@doctors.org.uk
Telephone: +44-1223245151 Fax: +44-1223-214094
Received: January 23, 2017
Peer-review started: January 29, 2017
First decision: May 11, 2017
Revised: May 28, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: July 18, 2017
Abstract
AIM

To systematically review the results of studies looking at autologous matrix-induced chondrogenesis (AMIC) in humans.

METHODS

A literature search was performed, adhering to the PRISMA guidelines, to review any studies using such techniques in humans. Our initial search retrieved 297 articles listed on MEDLINE, Google Scholar, CINHal and EMBASE. From these studies, 15 studies meeting the eligibility criteria were selected and formed the basis of our systematic review.

RESULTS

The study designs, surgical techniques and outcome measures varied between the studies. Although all studies reported improvements in patient outcome measures, this was not necessarily correlated with magnetic resonance imaging findings. Although there were many additional procedures performed, when AMIC was performed in isolation, the results tended to peak at 24 mo before declining.

CONCLUSION

Although short-term studies suggest improved patient reported outcomes with a variety of scaffolds, surgical techniques and rehabilitation regimes, the literature remains equivocal on whether the defect size and location, and patient factors affect the outcome. Patient benefit appears to be maintained in the short-to-medium term but more high level studies with extensive and robust validated outcome measures should be conducted to evaluate the medium- and long-term effect of the AMIC procedure.

Keywords: Autologous matrix-induced chondrogenesis, Cartilage defects, Humans, PRISMA

Core tip: Studies looking at autologous matrix-induced chondrogenesis (AMIC) in humans suggest improved patient reported outcomes in the short-to-medium term but there is significant variation in the scaffolds, surgical techniques and rehabilitation regimes used. The literature remains equivocal on whether the defect size and location, and patient factors affect the outcome. More high level studies with extensive and robust validated outcome measures should be conducted to evaluate the medium- and long-term effect of the AMIC procedure.