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

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.