Outcome of Autologous Matrix Induced Chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry

Abstract

IntroductionAutologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness 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 materialsPatients treated with AMIC (Chondro-Gide®, 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.ResultsA 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 cm2 (range 1.0–12.0 cm2). 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).ConclusionsAMIC 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 evidencePrognostic study, Level IV.

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

“…Autologous matrix-(or collagen-) induced chondrogenesis have shown good short-term (2-year) clinical outcomes. Autologous matrix-induced chondrogenesis, with the use of Chondro-gide 1 , demonstrated a 4-point decrease in visual analog scale (VAS) pain scores and a 35-point improvement in Lysholm scores at 2 years [11]. Autologous collageninduced chondrogenesis, with the use of atelocollagen, demonstrated a 30-point increase in Lysholm scores at 2 years [37].…”

“…In the setting of microfracture, this is referred to as autologous matrix-(or collagen-)induced chondrogenesis [11,37] and, in the setting of chondrocyte implantation, is known as matrix-assisted chondrocyte transplantation or second-/third-generation autologous chondrocyte transplantation, which is not currently available in the United States [20]. These biologic matrices are composed of cartilage extracellular matrix molecules or biopolymers that function as a scaffold for marrow components or transplanted chondrocytes to form more hyaline-like repair tissue in articular cartilage defects [35].…”

Autologous chondrocyte implantation for cartilage repair: current perspectives

“…In a perspective study, Gille 67 In another study, the same authors found a significant decrease of pain in the VAS (visual analog scale) at 1 and 2 years postoperatively. 68 Kusano et al 69 also detected significant improvements in functional scores and VAS after 29 months, but magnetic resonance imaging (MRI) findings showed generally incomplete or inhomogeneous tissue filling. Comparing AMIC with the original microfracturing technique, Anders et al 70 found no significant differences in the IKDC or Cincinnati score at 1 or 2 year follow-up.…”

Komplexe Gelenkrekonstruktion und Gelenktransplantation mit dem FLOCSAT-Konzept – Planung und chirurgische Umsetzung

“…Mikrofrakturierung (MF), autologe Chondrozytentransplantation (ACT), autologe matrixinduzierte Chondrogenese (AMIC) und andere Therapien sind wichtige Optionen zur Behandlung chondraler Läsionen. Bei großen subchondralen Läsionen, fehlendem intakten Knorpelrand [2,4,7,11,14], gegenüberliegenden ("kissing") Läsio- nen oder großen Knorpel-KnochenDefekten (> 10 cm 2 ) sind sie jedoch weniger geeignet. Die Heilung erfolgt hier über die Bildung eines Faserknorpels, dieser entspricht jedoch histologisch und somit auch biomechanisch nicht dem eines vollwertigen hyalinen Knorpels.…”