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Cartilage Grafting

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Hip Joint Restoration

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Abstract

Autologous matrix-induced chondrogenesis (AMIC) is a novel, one-step approach combining microfracture with a collagen type I/III matrix. It has been successfully established for treating cartilage defects in the knee and talus. In this chapter we present the arthroscopic application in the hip. Additionally we report clinical outcome data from 142 patients (age: 18–51 years) with femoro-acetabular impingement (FAI) who underwent arthroscopic treatment of medium-to-large chondral defects in the hip. The outcomes of 80 patients treated with ACI (34 with hyaluronic acid scaffold and 46 with polymer scaffold) and 62 with AMIC were assessed pre- and post-operatively (up to 7 years for ACI and up to 5 years for AMIC) using the modified Harris hip score (MHHS).

Baseline MHHS, mean post-operative MHHS and mean improvement at the end of the study (EOS) were similar for all groups. The mean MHHS at EOS were 81.1, 80.1 and 84.0 in patients undergoing ACI with hyaluronic acid scaffold, ACI with polymer scaffold and AMIC, respectively. The mean MHHS changes from baseline to EOS were 36.4, 35.7 and 39.4, respectively. The greatest improvement was observed in the first 6 months and up to 1 year after surgery. Improvements were maintained over time until the EOS.

Based on these results it is safe to conclude that arthroscopic ACI and AMIC both present clinically valid options for treating cartilage defects resulting from FAI with clear advantages for AMIC, especially with respect to cost-effectiveness.

Level of Evidence: Level III, retrospective therapeutic study.

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Acknowledgements

Medical writing was supported by nspm ltd, Meggen, Switzerland and by Geistlich Pharma AG.

Disclosure: The author declares that he has no conflict of interest.

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Authors and Affiliations

  1. Ortopedia, COF Lanzo Hospital, Località Caslè, 5, 22020, Ramponio Verna (Lanzo D’Intelvi), Como, Italy

    Andrea Fontana MD

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  1. Andrea Fontana MD
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Correspondence to Andrea Fontana MD .

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Editors and Affiliations

  1. Orthopedic Surgery, Hip Joint Arthroplasty, Hip Arthroscopy Massachusetts General Hospital, Boston, Massachusetts, USA

    Joseph C. McCarthy

  2. Institute of Orthopedic Research and Education, Houston, Texas, USA

    Philip C. Noble

  3. Consultant Orthopedic Surgeon Orthopedics, The Villar Bajwa Practice, Spire Cambridge Lea Hospital, Cambridge, United Kingdom

    Richard N. Villar

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Fontana, A. (2017). Cartilage Grafting. In: McCarthy, J., Noble, P., Villar, R. (eds) Hip Joint Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0694-5_67

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  • DOI: https://doi.org/10.1007/978-1-4614-0694-5_67

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