Comparison of Three Different Techniques for the Treatment of Cartilage Lesions: Matrix-Induced Autologous Chondrocyte Implantation (MACI) Versus Autologous Matrix-Induced Chondrogenesis (AMIC) and Arthroscopic Minced Cartilage. A 2-Year Follow up on Patient Reported Pain and Functional Outcomes

Background/Objectives: The treatment of cartilage damage is an ongoing challenge. Several techniques have been developed to address this problem. Matrix-Induced Autologous Chondrocyte Implantation (MACI) is often referred to as the 'gold standard' for cartilage treatment. Numerous long-term outcome studies also have reported favorable results with the Autologous Matrix-Induced Chondrogenesis (AMIC). Minced cartilage implantation (MIC) is a recently developed arthroscopic method. This technique has demonstrated promising outcomes with the prospect of longer-term results still under investigation. This study aims to directly compare the patient-reported outcomes of these three techniques over a two-year follow-up period. Methods: N = 48 patients were included into the retrospective matched pair analysis (n = 16 MACI, n = 16 AMIC, n = 16 MIC). The VAS, KOOS-Pain and KOOS- Symptoms scores served as primary outcomes, the KOOS- ADL, -QOL and the Tegner Activity Scale (TAS) as secondary outcomes. Results: All three groups did not differ from each other in the primary and secondary outcomes. Pain and function had significantly improved from pre surgery to two years after (VAS: p < .000; ES: ⴄ²=.27; KOOS-Pain: p < .000; ES: ⴄ²=.30; KOOS-Symptoms: p=.000; ES: ⴄ²=.26; KOOS-ADL: p < .000; ES: ⴄ² = .20; KOOS-QOL: p < .000; ES: ⴄ² = .30). There was no significant effect of time on the activity level. Conclusions: All three procedures show good patient-reported outcomes, low complication rates and long graft longevity in the two-year follow up. Therefore, all three Methods seem to be equally recommendable for the treatment of cartilage lesions.