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Autologous Matrix-Induced Chondrogenesis (AMIC): Combining Microfracturing and a Collagen I/III Matrix for Articular Cartilage Resurfacing.

Benthien JP, Behrens P - Cartilage (2010)

Bottom Line: This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane by a partially autologous fibrin glue.Indications and contraindications are provided; a technical note is given.This method is primarily applied in osteochondral lesions of the knee and ankle joints; other joints may qualify.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Basel, Basel, Switzerland.

ABSTRACT
Options for the treatment of cartilage defects include chondral resurfacing with abrasion, debridement, autologous chondrocyte transplantation (ACT), matrix-induced chondrocyte transplantation (MACI), or osteochondral autologous transplantation (OATS). This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane by a partially autologous fibrin glue. Indications and contraindications are provided; a technical note is given. This method is primarily applied in osteochondral lesions of the knee and ankle joints; other joints may qualify.

No MeSH data available.


Related in: MedlinePlus

(A) After curettage of the lesion, microfracturing may be performed. A blood clot should form. (B) Reproduced with kind permission by Geistlich (Wolhusen, Switzerland).
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fig2-1947603509360044: (A) After curettage of the lesion, microfracturing may be performed. A blood clot should form. (B) Reproduced with kind permission by Geistlich (Wolhusen, Switzerland).

Mentions: The procedure starts with an arthroscopy of the affected joint to verify the size and location of the defect and also the amount of accompanying disorder. If the size is located and an AMIC procedure is recommended, a minimally invasive arthrotomy is performed,11 and the defect is visualized openly (Fig. 1). The defective cartilage tissue and subchondral bone are removed with a curette. Microfracturing is performed with the corresponding microfracturing probes (Fig. 2). The size of the defect is evaluated, and a collagen membrane is measured. It should be slightly undersized to avoid dislocation after movement. An aluminum template may be used to determine the size of the lesion. For preparation of the fibrin glue, several options exist: a partially autologous fibrin glue may be manufactured by centrifuging a blood sample from the patient and mixing the yielded thrombin with allogenic fibrinogen. Completely allogenic fibrin glue as commercially available or suturing for fixation may also be performed. The partially autologous fibrin glue is the authors’ fixation method of choice. Suturing may also be performed but may lead to cartilage damage.6 Knecht et al. have confirmed that gluing with fibrin glue leads to sufficient stability.10 It should be kept in mind that according to the original method, the collagen membrane should be placed slightly below the cartilage level to avoid displacement. If the joint is gently moved intraoperatively, inspection of the site usually yields that the membrane remains in place. The membrane is attached to cover the defect (Figs. 3and4).


Autologous Matrix-Induced Chondrogenesis (AMIC): Combining Microfracturing and a Collagen I/III Matrix for Articular Cartilage Resurfacing.

Benthien JP, Behrens P - Cartilage (2010)

(A) After curettage of the lesion, microfracturing may be performed. A blood clot should form. (B) Reproduced with kind permission by Geistlich (Wolhusen, Switzerland).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4440611&req=5

fig2-1947603509360044: (A) After curettage of the lesion, microfracturing may be performed. A blood clot should form. (B) Reproduced with kind permission by Geistlich (Wolhusen, Switzerland).
Mentions: The procedure starts with an arthroscopy of the affected joint to verify the size and location of the defect and also the amount of accompanying disorder. If the size is located and an AMIC procedure is recommended, a minimally invasive arthrotomy is performed,11 and the defect is visualized openly (Fig. 1). The defective cartilage tissue and subchondral bone are removed with a curette. Microfracturing is performed with the corresponding microfracturing probes (Fig. 2). The size of the defect is evaluated, and a collagen membrane is measured. It should be slightly undersized to avoid dislocation after movement. An aluminum template may be used to determine the size of the lesion. For preparation of the fibrin glue, several options exist: a partially autologous fibrin glue may be manufactured by centrifuging a blood sample from the patient and mixing the yielded thrombin with allogenic fibrinogen. Completely allogenic fibrin glue as commercially available or suturing for fixation may also be performed. The partially autologous fibrin glue is the authors’ fixation method of choice. Suturing may also be performed but may lead to cartilage damage.6 Knecht et al. have confirmed that gluing with fibrin glue leads to sufficient stability.10 It should be kept in mind that according to the original method, the collagen membrane should be placed slightly below the cartilage level to avoid displacement. If the joint is gently moved intraoperatively, inspection of the site usually yields that the membrane remains in place. The membrane is attached to cover the defect (Figs. 3and4).

Bottom Line: This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane by a partially autologous fibrin glue.Indications and contraindications are provided; a technical note is given.This method is primarily applied in osteochondral lesions of the knee and ankle joints; other joints may qualify.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Basel, Basel, Switzerland.

ABSTRACT
Options for the treatment of cartilage defects include chondral resurfacing with abrasion, debridement, autologous chondrocyte transplantation (ACT), matrix-induced chondrocyte transplantation (MACI), or osteochondral autologous transplantation (OATS). This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane by a partially autologous fibrin glue. Indications and contraindications are provided; a technical note is given. This method is primarily applied in osteochondral lesions of the knee and ankle joints; other joints may qualify.

No MeSH data available.


Related in: MedlinePlus