Outcome Of Autologous Matrix Induced Chondrogenesis (Amic) In Cartilage Knee Surgery: Data Of The Amic Registry

Abstract

Introduction Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized fullthickness cartilage defects combining the well-known microfracturing with collagen I/III scaffold. The purpose of this analysis was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral lesions of the knee. Methods and materials Patients treated with AMIC (Chondro-Gide Ò , Geistlich Pharma, Switzerland) were followed using the AMIC Registry, an internet-based tool to longitudinally track changes in function and symptoms by the Lysholm score and VAS. Results A series of 57 patients was enrolled. The average age of patients (19 females, 38 males) was 37.3 years (range 17-61 years). The mean defect size of the chondral lesions was 3.4 cm 2 (range 1.0-12.0 cm 2 ). All defects were classified as grade III (n = 20) or IV (n = 37) according to the Outerbridge classification. Defects were localized at the medial (n = 32) or lateral (n = 6) condyle, at the trochlea (n = 4) and at the patella (n = 15). The follow-up period was 2 years. The majority of patients were satisfied with the postoperative outcome, reporting a significant decrease of pain (mean VAS preop = 7.0; 1 year postop = 2.7; 2 years postop = 2.0). Significant improvement of the mean Lysholm score was observed as early as 1 year after AMIC and further increased values were noted up to 2 years postoperatively (preop. 50.1, 1 year postop. 79.9, 2 year postop. 85.2). Conclusions AMIC is an effective and safe method of treating symptomatic chondral defects of the knee. However, further studies with long-term follow-up are needed to determine if the grafted area will maintain structural and functional integrity over time. Level of evidence Prognostic study, Level IV.

Matrix-Associated Autologous Chondrocyte Implantation

“…In order to evaluate the influence of the defect size on the clinical results 3 subgroups were analyzed as published before. 12 The individual groups (group I, defect size >0-3 cm 2 ; group II, <3-6 cm 2 ; group III, >3-6 cm 2 ) did not differ significantly in the score values. In 6 (40%) patients, the cartilage defect was located in the left knee and 9 defects (60%) were diagnosed in the right knee.…”

Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects

“…The use of an exogenous scaffold (e.g. collagen matrix) can provide mechanical stability for the primary cartilaginous repair tissue and can additionally represent a proper stimulation for MSCs towards chondrogenic differentiation and cartilage regeneration [11]. Accordingly, AMIC technique provides a solution by combining microfracturing with a collagen I/III matrix (Chondro-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) [6].…”

The surgical management of symptomatic articular cartilage defects of the knee: Consensus statements from United Kingdom knee surgeons

“…Clinical outcome is poor in the medium-term for young active patients or patients with larger defects [17,18]. Techniques are described for performing a microfracture with the addition of a membrane or matrix overlying the clot to retain the clot in the defect [19]. The longer-term outcome data of this technique is awaited.…”