EP6.6 Long term outcomes of AMIC + BMAC for large acetabular cartilage lesions in cam-type FAI

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ID: 330980
2026
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Abstract
Abstract We report on the 7-to-10-year results of a consecutive series of 37 hips treated with arthroscopic Autologous Matrix Induced Chondrogenesis (AMIC) supplemented with Bone Marrow Aspirate Concentrate (BMAC) for Acetabular Cartilage Lesions in patients with cam-type Femoro-Acetabular Impingement (FAI). Materials and Methods Twenty-nine men (4 bilateral hips) and 4 women with a mean age of 29 years (range 17- 42) were treated between 2015 and 2018 for full thickness acetabular cartilage lesions greater than 125 mm2. Mean cartilage defect was 275 mm2 (range 125-550). Twenty hips were graded Tönnis stage 0, 14 stage I and 3 stage II. Seven hips were arthroscopic revision procedures; 34 had cam resection during the index procedure; 23 had labral repair. Mean preop CE-angle was 27 (range 17-33); 9 hips had (borderline) dysplasia. A multivariable and univariate logistic regression for 15 candidate variables were analyzed to identify risk factors for failure. Results One patient was lost to FU. Mean FU was 95 months (range 72-120). Eight hips required revision surgery (6 HRA and 2 THR). Kaplan-Meier survival analysis yielded an estimated 10-year survival free of revision of more than 80 %. Subjective outcomes were excellent (28), good (5), and fair at final FU. Mean UCLA at final FU was 9.4. Although initial return to sports was high, patients frequently changed sports type over time. Sixty percent of patients continued to practice any sport at final FU, but high-impact sports decreased from 28 to 16 patients mainly due to other injuries (knee, spine). In the multivariable logistic regression, risk factors for failure were identified. The statistic correlation was most relevant for age (young patients, OR 0.84 per year, 95 % CI 0.71–0.99, p=0.038) and Tönnis grade (OR 4.26, 95 % CI 0.87–20.8, p=0.073). Sex and lesion size were not significant predictors. Univariate analysis identified pre-operative bone oedema on MRI as the strongest risk factor for failure (OR ≈9.75, 95 % CI 2.11–45.00, p=0.0035). Revision surgery carried a higher risk of treatment failure (OR 3.1, 95% CI 0.7-13.5) but this was not statistically significant (p=0.14). Conclusions Arthroscopic AMIC with BMAC for larger acetabular cartilage lesions provides durable pain relief and functional improvement up to 10 years. Although two-thirds of patients remained active, high-impact sport participation declined significantly over time, which may also be reflecting age-related changes rather than failure of the chondral repair. The results favour well compared to a group of patients with similar type of cartilage defects and treated with AMIC only.
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Authors J Somers, Neal Jansen, Arne Hermans, Mathieu De Jonghe
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.362
URL
https://doi.org/10.1093/jhps/hnag043.362
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