Autologous matrix-induced chondrogenesis explained

Autologous matrix-induced chondrogenesis (AMIC) is a treatment for articular cartilage damage. It combines microfracture surgery with the application of a bi-layer collagen I/III membrane.There is tentative short to medium term benefits as of 2017.[1]

The initialism AMIC, often used as a genericized trademark, is a registered trademark of Ed. Geistlich Söhne AG, protected by German Registration No. 30255356 [2] and international Registration No. 840373.[3]

Procedure

See also: Knee cartilage replacement therapy.

Autologous Matrix Induced Chondrogenesis (AMIC) surgery is a single step procedure. After arthroscopic evaluation of the cartilage damage and decision for an AMIC procedure a mini arthrotomy is performed. An all-arthroscopic AMIC procedure for repair of cartilage defects of the knee is also possible.[4]

History

The AMIC procedure was first proposed by Behrens in 2003. it aims to extend the use of microfracture surgery to larger cartilage lesions > 2.5 cm2.[5] Its clinical efficiency in autologous chondrocyte implantation (ACI), another cartilage repair technique for larger cartilage lesions, has been studied.[6] [7] [8]

In general various factors have been identified known to influence the result after cartilage repair regardless of the technique used. Amongst them are the species and age of the individual, the size and localization of the articular cartilage defect, the surgical technique, and the postoperative rehabilitation protocol.[9] [10] The latter has been found especially important for microfracture surgery and therefore for AMIC.[11]

The basic procedure of Microfracture surgery was developed by JR Steadman in the late 80’s and early 90’s. It is a well documented cartilage repair technique and first line treatment option for small cartilage lesions.[12] [13] [14] AMIC evolved with the aim to improve some of the shortfalls of microfracture surgery as for instance variable repair cartilage volume and functional deterioration over time.[15]

Notes and References

  1. Shaikh. N. Seah. MKT. Khan. WS. Systematic review on the use of autologous matrix-induced chondrogenesis for the repair of articular cartilage defects in patients.. World Journal of Orthopedics. 18 July 2017. 8. 7. 588–601. 10.5312/wjo.v8.i7.588. 28808630. 5534408. free.
  2. Web site: Deutsche Patent- und Markenamt (DPMA), registration # 30255356 . 2002-11-11 . 2013-01-25.
  3. Web site: World Intellectual Property Organization (WIPO), registration # 840373 . 2004-08-18 . 2013-01-25.
  4. Piontek. Tomasz . Ciemniewska-Gorzela Kinga . Szulc Andrzej . Naczk Jakub . Słomczykowski Michał. All-arthroscopic AMIC procedure for repair of cartilage defects of the knee. Knee Surgery, Sports Traumatology, Arthroscopy. 30 August 2011. 922–925. 10.1007/s00167-011-1657-z. 0942-2056 . 20. 5 . 21910000 . 3332359 .
  5. 10.1007/s00142-005-0316-0. Behrens P.. 2005. Matrixgekoppelte Mikrofrakturierung. Arthroskopie. 18. 3. 193–197. P.. 30000568.
  6. 10.1177/0363546509348477. Gomoll AH, Probst C, Farr J, Cole BJ, Minas T . Use of a type I/III bilayer collagen membrane decreases reoperation rates for symptomatic hypertrophy after autologous chondrocyte implantation. Am J Sports Med . 37. 20S–23S . November 2009. Suppl 1 . 0363-5465. 19841142. 206524323 .
  7. 10.1016/j.arthro.2006.12.003. Steinwachs M, Kreuz PC . Autologous chondrocyte implantation in chondral defects of the knee with a type I/III collagen membrane: A prospective study with a 3-year follow-up . Arthroscopy . 23. 4. 381–387. April 2007 . 1526-3231. 17418330.
  8. 10.1016/j.knee.2006.02.011. Gooding CR, Bartlett W, Bentley G, Skinner JA, Carrington R, Flanagan A . A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: Periosteum covered versus type I/III collagen covered . Knee . 13. 3. 203–10 . Jun 2006 . 0968-0160. 16644224.
  9. Alford JW, Cole BJ . Cartilage restoration, part 2: techniques, outcomes, and future directions . Am J Sports Med . 33. 3. 443–460 . Mar 2005 . 0363-5465 . 15716263. 10.1177/0363546505274578. 11361026 .
  10. 10.1016/j.injury.2008.01.042. Steinwachs MR, Guggi T, Kreuz PC . Marrow stimulation techniques . Injury . 39. S26–31 . Apr 2008 . Suppl 1 . 0020-1383 . 18313469.
  11. 10.1016/j.csm.2009.12.009. Hurst JM, Steadman JR, O'Brien L, Rodkey WG, Briggs KK . Rehabilitation following microfracture for chondral injury in the knee . Clin Sports Med . 29 . 2 . 257–65, viii . Apr 2010 . 1556-228X. 20226318.
  12. 10.1016/S1048-6666(97)80033-X. Steadman JR, Rodkey WG, Singleton SB, Briggs KK . Microfracture technique for full-thickness chondral defects: Technique and clinical results . Oper Tech Orthop . 7 . 4 . 300–304 . October 1997.
  13. Steadman JR, Rodkey WG, Rodrigo JJ . Microfracture: surgical technique and rehabilitation to treat chondral defects . Clin Orthop Relat Res . 391 Suppl . S362–9 . Oct 2001 . 391 . 10.1097/00003086-200110001-00033 . 0009-921X . 11603719.
  14. 10.1053/jars.2003.50112. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG . Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up . Arthroscopy . 19 . 5 . 477–84 . May–Jun 2003 . 1526-3231 . 12724676.
  15. 10.1177/0363546508328414. Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR . Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis . Am J Sports Med . 37 . 10 . 2053–63 . Oct 2009 . 1552-3365 . 19251676 . 206523609 .

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