Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-08-2011 | Knee

The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments

Authors: Jan Philipp Benthien, Peter Behrens

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2011

Abstract

Purpose

Articular resurfacing by treatment of chondral defects may include chondral abrasion, autologous chondrocyte Implantation (ACI), matrix-induced chondrocyte transplantation (MACT) or osteochondral autologous transplantation (OATS). This technical note describes the method of autologous matrix-induced chondrogenesis (AMIC), a one-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane with fibrin glue or sutures.

Methods

This is a technical note on the AMIC procedure and its further development.

Results and conclusion

This method is applied primarily in chondral or osteochondral lesions of the knee. Indications and contraindications are provided; the technique is described. The further development of AMIC is described with an increased focus on the subchondral zone and the complex of cartilage and bone, the osteochondral unit, which receives increased attention in cartilage research.

Level of evidence

IV.

Bartlett W, Skinner JA, Gooding CR, Carrington RWJ, Flanagan AM, Briggs TWR, Bentley G (2005) Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee. A prospective randomized study. J Bone Joint Surg Br 87:640–645PubMedCrossRef

Behrens P, Bosch U, Bruns J et al (2004) Indications and implementation of recommendation of the working group “Tissue regeneration and Tissue Substitution” for autologous chondrocyte transplantation. Z Orthop Ihre Grenzgeb 142:529–539PubMedCrossRef

Behrens P, Bitter T, Kurz B et al (2006) Matrix associated autologous chondrocyte transplantation: a 5 year follow up. Knee 13:194–202PubMedCrossRef

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

Benthien JP, Schwaninger M, Behrens P (2010) We do not have evidence based methods for the treatment of cartilage lesions in the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-010-1271-5

Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, Skinner JA, Pringle J (2003) A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br 85:223–230PubMedCrossRef

Bert JM, Maschka K (1989) The arthroscopic treatment of unicompartimental gonarthrosis: a five year follow up study of abrasion arthroplasty plus arthroscopic débridement and arthroscopic débridement alone. Arthroscopy 5:25–32PubMedCrossRef

Brittberg M (2008) Autologous chondrocyte implantation-technique and long-term follow-up. Injury 39:S40–S49PubMedCrossRef

Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 14:889–895CrossRef

10.

Chen H, Sun J, Hoemann C, Lascau-Coman V, Ouyang W, Tran-khanh N, Chevrier A, McKee M, Shive M, Buschmann M (2009) Drilling and microfracture lead to different bone structure and necrosis during bone-marrow stimulation for cartilage repair. J Orthop Res 11:1432–1438CrossRef

11.

Dozin B, Malpeli M, Cancedda R, Bruzzi P, Calcagno S, Molfetta L, Priano F, Kon E, Marcacci M (2005) Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med 15:220–226PubMedCrossRef

12.

Friedmann MJ, Berasi CC, Fox JM et al (1984) Preliminary results with abrasion arthroplasty in the osteoarthritic knee. Clin Orthop Rel Res 18:200–205

13.

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 18:1456–1464PubMedCrossRef

14.

Gille J, Meisner U, Ehlers EM, Mueller A, Russlies M, Behrens P (2005) Migration pattern, morphology and viability of cells suspended in or sealed with fibrin glue: a histomorphologic study. Tissue Cell 37:339–348PubMedCrossRef

15.

de Girolamo L, Bertolini G, Cervellin M et al (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 41:1172–1177PubMedCrossRef

16.

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 18:434–447PubMedCrossRef

17.

Knecht S, Erggelet C, Endres M, Sittinger M, Kaps C, Stuessi E (2007) Mechanical testing of fixation techniques for scaffold-based tissue-engineered grafts. J Biomed Mater Res B Appl Biomater 83:50–57PubMed

18.

Knutsen G, Drogset JO, Engebretsen L, Grøntvedt T, Isaksen V, Ludvigsen TC, Roberts S, Solheim E, Strand T, Johansen O (2007) A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at five years. J Bone Joint Surg Am 89:2105–2112PubMedCrossRef

19.

Kramer J, Boehrnsen F, Lindner U, Behrens P, Schlenke P, Rohwedel J (2006) In vivo matrix guided human mesenchymal stem cells. Cell Mol Life Sci 6:616–626CrossRef

20.

Mithoefer K, Wiliams RJ, Potter WarrenRF, HG SpockCR, Jones EC, Wickiewicz T, Marx RG (2005) The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective Cohort study. J Bone Joint Surg Am 87:1911–1920PubMedCrossRef

21.

Skodacek D, Rotter N et al (2008) Growth factors and scaffold composition influence properties of tissue engineered human septal cartilage implants in a murine model. Int J Immunopathol Pharmacol 21:807–816PubMed

22.

Steadman JR, Briggs KK, Rodrigo JJ, Kocher MM, Gill TJ, Rodhen WG (2003) Outcomes of microfracture for traumatic chondral defects of the knee-average 11 year follow up. Arthroscopy 15:477–484CrossRef

23.

Steadman JR, Rodkey WG, Rodrigo JJ (2001) Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res 391:S362–S369PubMedCrossRef

Title: The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments
Authors: Jan Philipp Benthien
Peter Behrens
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-010-1356-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments

Abstract

Purpose

Methods

Results and conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results and conclusion

Level of evidence

Please log in to get access to this content

Other articles of this Issue 8/2011

Relationship between thickness of the anteromedial bundle and thickness of the posterolateral bundle in the normal ACL

Pseudoaneurysm of the superior medial genicular artery following knee arthroscopy

Intraoperative comparisons of knee kinematics of double-bundle versus single-bundle anterior cruciate ligament reconstruction

Arthroscopic pullout repair of posterior root tear of the medial meniscus: the anterior approach using medial collateral ligament pie-crusting release

Education in arthroscopy, sports medicine and knee surgery

Mid-portion Achilles tendinopathy: why painful? An evidence-based philosophy