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

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. METHODS: PubMed and Cochrane were queried in June 2022 to conduct this systematic review using the following keywords "femoroacetabular 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 criteria. Each study was queried for demographics, lesion classification, surgical treatment, patient-reported outcome scores, revision arthroscopy, and conversion to total hip arthroplasty (THA). A qualitative subanalysis 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 4 included studies reported the modified Harris Hip Score, and all 3 of these studies reported statistically significant improvement in the modified Harris Hip Score at final follow-up (P < .001) with mean preoperative values ranging from 44.5 to 62.8 and mean postoperative values ranging from 78.8 to 95.8. Two of the 4 studies compared patients treated with AMIC to microfracture alone. In these 2 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%). CONCLUSIONS: Patients who underwent hip arthroscopy and AMIC for the treatment of femoroacetabular impingement syndrome and acetabular chondral lesions demonstrated improved patient-reported outcomes and low rates of secondary surgeries at short-term follow-up. STUDY DESIGN: Level IV, systematic review of Level III and IV studies.