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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Autologous matrix-induced chondrogenesis (AMIC) is a treatment for focal full-thickness cartilage defects combining microfracturing with an exogenous I/III collagen matrix (Chondro-Gide). The aim of the present study was to determine the 7 years outcomes of patients treated with the AMIC technique for knee chondral defects larger than 2 cm2. The hypothesis was that the positive short-term outcomes achieved in the previous series would not deteriorate at a 7-year follow-up.

Methods

Twenty-one patients treated with the AMIC technique were retrospectively analysed. Patients were assessed through the IKDC subjective knee evaluation questionnaire and the Lysholm scoring system. All patients underwent a complete imaging study including radiographs and magnetic resonance. The median defect size was found to be 4.3 (range 2.9–8) cm2.

Results

At a median follow-up of 7 (±1.4) years, the mean IKDC score improved from 31.7 (±8.9) points preoperatively, to 80.6 (±5.3) at the latest follow-up (p < 0.05). The mean Lysholm score improved from 38.8 (±12.4) points preoperatively to 72.6 (±19.5) points at the last follow-up (p < 0.05). At the last follow-up, 76.2% of patients were satisfied or extremely satisfied with their outcomes, while 66.6% of patients showed good quality repair tissue on magnetic resonance imaging.

Conclusion

AMIC was found to be an effective method to treat full-thickness knee chondral defects larger than 2 cm2, with significant clinical and functional improvement maintained over a 7-year follow-up.

Level of evidence

IV.

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References

  1. Anders S, Volz M, Frick H, Gellissen J (2013) A randomized, controlled trial comparing autologous matrix-induced chondrogenesis (AMIC®) to microfracture: analysis of 1- and 2-year follow-up data of 2 centers. Open Orthop J 3:133–143

    Article  Google Scholar 

  2. Arøen A, Løken S, Heir S, Alvik E, Ekeland A, Granlund OG, Engebretsen L (2004) Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med 32:211–215

    Article  PubMed  Google Scholar 

  3. Bae DK, Song SJ, Yoon KH, Heo DB, Kim TJ (2013) Survival analysis of microfracture in the osteoarthritic knee-minimum 10-year follow-up. Arthroscopy 29:244–250

    Article  PubMed  Google Scholar 

  4. Bark S, Piontek T, Behrens P, Mkalaluh S, Varoga D, Gille J (2014) Enhanced microfracture techniques in cartilage knee surgery: fact or fiction? World J Orthop 18:444–449

    Article  Google Scholar 

  5. Bedi A, Feeley BT, Williams RJ (2010) Management of articular cartilage defects of the knee. J Bone Joint Surg Am 92:994–1009

    Article  PubMed  Google Scholar 

  6. Benthien JP, Behrens P (2010) Autologous matrix-induced chondrogenesis (AMIC). A one-step procedure for retro - patellar articular resurfacing. Acta Orthop Belg 76:260–263

    PubMed  Google Scholar 

  7. De Girolamo L, Bertolini G, Cervellin M, Sozzi G, Volpi P (2010) Treatment of chondral defects of the knee with one step matrix-assisted technique enhanced by autologous concentrated bone marrow: In vitro characterisation of mesenchymal stem cells from iliac crest and subchondral bone. Injury 41:1172–1177

    Article  PubMed  Google Scholar 

  8. Dhollander A, Moens K, Van der Maas J, Verdonk P, Almqvist KF, Victor J (2014) Treatment of patellofemoral cartilage defects in the knee by autologous matrix-induced chondrogenesis (AMIC). Acta Orthop Belg 80:251–259

    PubMed  Google Scholar 

  9. Enea D, Cecconi S, Calcagno S, Busilacchi A, Manzotti S, Gigante A (2015) One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate: a pilot study. Knee 22:30–35

    Article  CAS  PubMed  Google Scholar 

  10. Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH (2010) Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc 42:1795–1780

    Article  PubMed  Google Scholar 

  11. Gille J, Behrens P, Volpi P, de Girolamo L, Reiss E, Zoch W, Anders S (2013) Outcome of autologous matrix induced chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry. Arch Orthop Trauma Surg 133:87–93

    Article  CAS  PubMed  Google Scholar 

  12. Gille J, Schuseil E, Wimmer J, Gellissen J, Schulz AP, Behrens P (2010) Mid-term results of autologous matrix induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 18:1456–1464

    Article  CAS  PubMed  Google Scholar 

  13. Gomoll AH, Madry H, Knutsen G, van Dijk N, Seil R, Brittberg M, Kon E (2010) The subchondral bone in articular cartilage repair: current problems in the surgical management. Knee Surg Sports Traumatol Arthrosc 18:434–447

    Article  PubMed  PubMed Central  Google Scholar 

  14. Goyal D, Keyhani S, Lee EH, Hui JH (2013) Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy 29:1579–1588

    Article  PubMed  Google Scholar 

  15. Kon E, Filardo G, Di Matteo B, Perdisa F, Marcacci M (2013) Matrix assisted autologous chondrocyte transplantation for cartilage treatment. Syst Rev Bone Joint Res 2: 18–25

    Article  CAS  Google Scholar 

  16. Kusano T, Jakob RP, Gautier E, Magnussen RA, Hoogewoud H, Jacobi M (2012) Treatment of isolated chondral and osteochondral defects in the knee by autologous matrix induced chondrogenesis (AMIC). Knee Surg Sports Traumatol Arthrosc 20:2105–2111

    Article  Google Scholar 

  17. Pascarella A, Ciatti R, Pascarella F, Latte C, Di Salvatore MG, Liguori L, Iannella G (2010) Treatment of articular cartilage lesions of the knee joint using a modified AMIC technique. Knee Surg Sports Traumatol Arthrosc 18:509–513

    Article  PubMed  Google Scholar 

  18. Piontek T, Ciemniewska-Gorzela K, Szulc A, Naczk J, Słomczykowski M (2012) Allarthroscopic AMIC procedure for repair of cartilage defects of the knee. Knee Surg Sports Traumatol Arthrosc 20:922–925

    Article  PubMed  Google Scholar 

  19. Sadlik B, Wiewiorski M (2015) Implantation of a collagen matrix for an AMIC repair during dry arthroscopy. Knee Surg Sports Traumatol Arthrosc 23:2349–2352

    Article  PubMed  Google Scholar 

  20. Schiavone Panni A, Cerciello S, Vasso M (2011) The manangement of knee cartilage defects with modified AMIC technique: preliminary results. Int J Immunopathol Pharmacol 24(1 Suppl 2):149–152

    Article  CAS  PubMed  Google Scholar 

  21. Williams SK, Amiel D, Ball ST, Allen RT, Tontz WL Jr, Emmerson BC, Badlani NM, Emery SC, Haghighi P, Bugbee WD (2007) Analysis of cartilage tissue on a cellular level in fresh osteochondral allograft retrievals. Am J Sports Med 35:2022–2032

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Multidisciplinary Department of Medico-Surgical and Dentistry Specialties, University “Campana Luigi Vanvitelli”, Napoli, Italy

    Alfredo Schiavone Panni, Giuseppe Mazzitelli, Rocco D’Apolito & Michele Vasso

  2. Department of Medicine and Health Sciences, University of Molise, Via Francesco De Sanctis, 86100, Campobasso, Italy

    Chiara Del Regno & Katia Corona

Authors
  1. Alfredo Schiavone Panni
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  2. Chiara Del Regno
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  3. Giuseppe Mazzitelli
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  4. Rocco D’Apolito
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  5. Katia Corona
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  6. Michele Vasso
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Corresponding author

Correspondence to Katia Corona.

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The authors declare that they have no conflict of interest.

Additional information

This work was performed at the Department of Medicine and Health Sciences of University of Molise, Campobasso, Italy.

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Schiavone Panni, A., Del Regno, C., Mazzitelli, G. et al. Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc 26, 1130–1136 (2018). https://doi.org/10.1007/s00167-017-4503-0

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  • DOI: https://doi.org/10.1007/s00167-017-4503-0

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