Treatment of articular cartilage lesions of the knee joint using a modified AMIC technique

Abstract

This study describes a modified AMIC technique consisting of perforations according to Pridie, rather than microfractures, and the covering of the focus of the lesion with a biological collagen patch enriched with bone marrow blood drawn through the knee itself. This technique allows advantages of both the Pridie technique and the in situ proliferation of mesenchymal cells beneath a biological collagen membrane, 'augmented', with bone marrow blood. The collagen membrane forms the roof of a 'biological chamber', and serves to protect and contains the stem cells as they differentiate into chondrocytes, which will form a healthy regenerative cartilage.

Surgical Technique: Second-generation Bone Marrow Stimulation via Surgical Dislocation to Treat Hip Cartilage Lesions

“…The authors did not attempt to correlate the functional results with the radiographic appearance of the lesion. Other smaller cohorts with a minimum of 1-year followup have reported improvement in knee-specific outcome scores [17,49]. Dhollander et al [17] observed intralesional osteophytes on MRI performed 1 to 2 years postoperatively in three of five patients.…”

The Manangement of Knee Cartilage Defects with Modified Amic Technique: Preliminary Results

“…This is mainly due to the extreme heterogeneity of size and position of these lesions as well as patients related factors. Microfractures have proven to be a reliable option with good results in up to 80% of patients (25,18). The AMIC technique can be defined as an evolution ofmicrofractures with the advantage ofmore stable blood cloth and chondrocyte differentiation from MSCs on a collagen matrix.…”

A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years

“…Overall, our data are in agreement with the results of Gille et al reporting a significant improvement in clinical outcomes in patients treated with AMIC ® , assessed by five different scores up to 36 months [22]. Similar results were found in a larger multicentre observational study including 57 patients 2/3 3 2 2 5 1 3 5 1 1 >2/3 5 2 2 9 10 4 6 8 6 not evaluable 0 0 0 1 0 0 0 0 0 Surface largely uneven 4 3 5 2 2 4 4 3 3 partially uneven 4 1 3 11 6 3 6 4 4 smooth 3 3 0 2 6 2 2 4 1 not evaluable 0 0 1 1 1 2 2 3 4 Integration marginal gap up to 50% ® using Pridie perforations instead of MFx, assessed up to 36 months with significant improvement in clinical scores and reduction of the defect area [24]. Similar results were shown for 17 patients with a larger mean defect size and 76% of the patients were satisfied or extremely satisfied [25].…”