Systematic review on the use of autologous matrix-induced chondrogenesis for the repair of articular cartilage defects in patients

Table 1 Study demographics, lesion location and grade, inclusion and exclusion criteria, and funding sources

Ref.	Treatment period	Patient numbers	Mean age (yr)	Mean follow-up in months (range)	Joint	Defect location and type	Grade of lesion	Lesion dimensions (cm2)	Inclusions	Exclusions	Source of funding
Shetty et al[34]	4 yr	30				MFC, LFC, trochlea, patella	Grade III/IV	2-8		Malalignment of the knee exceeding 5° of valgus or varus. Generalized osteoarthritic changes in the knee
Buda et al[15]	Apr 2006-May 2007	20 (12M, 8F)	15-50	29	Knees		Grade III/IV	Not specified		Diffuse arthritis, general medical conditions (e.g., diabetes, rheumatoid arthritis etc.), haematological disorders and infections	None
Gille et al[26]	2003-2005	27 (16M, 11F)	39	37 (24-62)	Knees	Medial femoral condyle 7, lateral femoral condyle 3, patella 9, trochlea 2, femoral condyle and patella 6	Grade IV	> 1	Clinical symptomatic chondral lesions at femoral condyle, patella or trochlea	Advanced osteoarthritis, rheumatic disease, total menisectomy, BMI > 35, deviation of mechanical axis to the affected compartment	Not specified
Dhollander et al[16]	Jan 2008-Apr 2008	5 (3M, 2F)	18-50	24 (12-24)	Knees	Patella	Grade III/IV	2 (range 1-3)	Symptomatic focal patella cartilage defects	Untreatable tibiofemoral or patellofemoral malalignment, diffuse osteoarthritis, major meniscal deficiency or other general medical conditions	Not specified
Dhollander et al[13]	2008-2009	5 (4M, 1F)	29.8	24	Knees	Right 2 (40%), left 3 (60%) medial femoral condyle (2), lateral femoral condyle (2), trochlea (1)	Grade III/IV	Median 2.3, range 1.5-5	16-40 yr, single symptomatic focal cartilage defect on femoral condyles or patellofemoral joint	Untreated tibiofemoral or patellofemoral malalsignment or instability, diffuse osteoarthritis, bipolar “kissing” lesions, major meniscal deficiency and other general medical conditions	Not specified
Kusano et al[22]	Aug 2003-Jul 2006	40 (23M, 17F)	35.6	28.8 (13-51)	Knees	Full thickness chondral defect in patella (20), femoral condyle (9), osteochondral defect in femoral condyle (11)	Grade III/IV	3.87		Defects in other locations, age > 50 yr, skeletally immature	Not specified
Leunig et al[23]	Mar 2009-Dec 2010	6 (5M, 1F)	22.7	Not specified (12-30)	Hips	Femoral head 5, acetabular 1 chondral 1, osteochondral 5	Grade III/IV	> 2	Full thickness chondral lesions > 2 cm2 or osteochondral lesions > 1 cm2 with defects in weight-bearing areas of acetabulum or femoral head, irreparable by osteotomy in age < 35 yr	Patients unwilling or unable to comply with post-operative rehabilitation protocols. Systematic inflammatory arthritis, advanced arthritis involving both femur and acetabulum, or age > 35 yr	Not specified
Pascarella et al[24]	2006-2008	19 (12M, 7F)		12-36	Knees	Right knee: Femoral condyle (medial 34%, lateral 14%), patella (9%) Left knee: Femoral condyle (medial 29%, lateral 14%)	Grade III/IV	3.6	Age 18-50 yr with single lesion	Osteoarthritis, axial deviations, ligamentous injuries, complete meniscal resection, allergy to collagen membrane components	Not specified
Anders et al[3]	Jan 2004-Mar 2010	38 (Not specified)	37	19 (6-24)	Knees		Grade III/IV	3.4	Age 18-50 yr, 1-2 lesions	> 2 defects, corresponding defects, bilateral defects, signs of osetoarthritis, other general diseases, history of complete menisectomy, mosaicplasty, treatment with cartilage specific medication, chondropathia patallae or patellar dysplasia	None
Gille et al[28]	Not specified	57 (38M, 19F)	37.3	24	Knees	Medial condyle (32), lateral condyle (6), trochlea (4), patella (15) Grouping based on lesion size: Group A 0-3 cm2, Group B 3-6 cm2, Group C 6-9 cm2	Grade III (35), Grade IV (37)	3.4 (1-12)	Age 17-61 yr	Rheumatic disease, total meniscectomy, and revision surgery	Not specified
Valderrabano et al[17]		26 (18M, 8F)	33	31 (25-54)	Ankles	Osteochondral lesions of talus		1.68	First time osteochondral lesion or failure of previous lesion	Age > 55 yr, open ankle physis	Not specified
Wiewiorski et al[25]	2008-2010	23 (16M, 7F)	34	23 (11-49)	Ankles (talus)	Osteochondral lesions of talus	Osteochondral	1.49	Single lesion with history of ankle trauma		Not specified
Dhollander et al[29]	April 2009-May 2011	10 (8M, 2F)	37.2 ± 7.1	24	Knee	Patella (8), trochlea (2)	Grade III/IV	4.2 ± 1.9	Patients aged 18-50 yr with a focal patellofemoral defect and clinical symptoms (pain, swelling, locking, giving way)	Untreatable tibio-femoral or patellofemoral mal - alignment or instability, diffuse osteoarthritis or bipolar “kissing” lesions, major meniscal deficiency and other general medical conditions (diabetes, rheumatoid arthritis)	Not specified
Mancini et al[30]	November 2004-June 2007	31	36.4 ± 10.3	60	Hip	Acetabular chondral defects	Grade III/IV	2-4	Patients 18-50 yr of age with acetabular chondral lesions with radiological Tönnis degree < 2 followed up to 5 yr	Concomitant chondral femoral head kissing lesion, systemic rheumatoid diseases, dysplasia, femoral neck axial deviations, coxa profunda, protrusio acetabuli	Not specified
Fontana et al[31]	November 2004-March 2011	55	39.1 (18 to 55)	36-60	Hip	Acetabular ± femoral head chondral defects	Grade III/IV	2-8	Patients 18-55 years of age with acetabular ± femoral head chondral lesions with radiological Tönnis degree < 2 followed up for 3-5 yr	Rheumatoid arthritis, dysplasia, axial deviation of the femoral neck, coxa profunda, protrusio acetabuli	Not specified but Girolamo is a paid consultant for Geistlich
Kubosch et al[32]	Not specified	17	38.8 ± 15.7	39.5 ± 18.4	Ankle	Osteochondral lesions of talus	Grade III/IV	2.4 ± 1.6	First-time diagnosis or failure of a previous operative treatment	Arthritis of the ankle joint, kissing lesions and rheumatoid arthritis	Not specified

BMI: Body mass index.