Cartilage defects are debilitating injuries that can reduce quality of life in patients. However, the poor regenerative properties of cartilage mean that cartilage repair remains challenging, and many methods have arisen to address that. Autologous Matrix-Induced Chondrogenesis (AMIC®) is a popular technique to manage cartilage defects. Recent advances have allowed AMIC® to be done arthroscopically, instead of a mini-open arthrotomy approach. This systematic review and meta-analysis aims to investigate whether the arthroscopic approach to AMIC® provides better clinical outcomes compared to the mini-open approach, in hopes of delineating a gold standard in cartilage repair.
With reference to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic search of the following databases (PubMed, Embase, Scopus, and Cochrane Library) was performed on 26th October 2022 using a combination of the following search terms: “autologous matrix induced “chondrogenesis” and “knee”. A total of 390 studies were identified, of which 24 studies were included in our final analysis.
The arthroscopic approach achieves lower Visual Analogue Scale (VAS) for pain scores. International Knee documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) were comparable between arthroscopic and open approaches. The open approach achieves a higher Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Incidence of reported postoperative complications of revision surgery and knee stiffness was higher for the open approach compared with arthroscopic, whereas deep vein thrombosis was higher in the arthroscopic approach.
The AMIC® repair outcomes indicate that the arthroscopic approach does not hold a distinct advantage over the open approach. The choice of approach should consider surgeon expertise, location of lesion, and patient-specific factors.
Systematic review and meta-analysis; Level III.

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