AMIC® Chondro-Gide®
AMIC® Chondro-Gide® is a minimally-invasive 1-step procedure that can be performed either by mini-open surgery, or in an arthroscopic manner. Developed by Geistlich Surgery in collaboration with leading surgeons in Europe, this technique has been effective in repairing chondral or osteochondral defects in the knee, talus, and hip.1,2,3
The Benefits of Using AMIC® Chondro-Gide®
With both mini-open and arthroscopic techniques, the unique advantage of AMIC® Chondro-Gide® is that it supports the body’s own potential to heal itself. Damaged cartilage is removed, and then bone marrow stimulation (BMS) techniques are used to bring regeneration supporting cells to the defect site.
The membrane covers the defect and serves as a protective shield that contains the cells and minimizes the impact of shear forces on the delicate superclot. At the same time, it functions as the roof of a biological chamber that forms over the defect. The biocompatible collagen material provides an environment for cell growth4 and is replaced by new cartilage tissue over time.5
Developed to Support Regeneration: AMIC® Chondro-Gide®
Using a standard, minimally invasive anterior approach, open the joint. Remove damaged and unstable cartilage until a stable, perpendicular shoulder surrounds the defect.
To get an exact impression of the defect, place the sterile aluminum template included with the Chondro-Gide® in the defect. Cut out the imprint and transfer it onto the membrane. Place the side that was facing the defect on the smooth side of the Chondro-Gide®.
Remember to trim the Chondro-Gide® so it is 10-15% smaller than the template, as the area of the Chondro-Gide® will expand when moistened. If needed, use a sterile pen to lightly mark the smooth (top) layer that will face the joint cavity. The “UP” sign might not be visible any more once you have cut or moistened the membrane.
Use a sharp awl or drill to perforate the subchondral bone at the base of the lesion. Start at the periphery of the lesion and then move toward the center at intervals of 3-4 mm.5
Carefully remove the residual tissue and check for adequate subchondral bleeding.
Apply fibrin glue directly to the subchondral bone plate around the perforations.
Place the Chondro-Gide® into the defect with the rough (bottom) layer facing the bone surface. Moisten the membrane until it is fully saturated. Check the position of the membrane and close. Once the glue has set, after about 5 minutes, use a sharp scalpel to remove the excess fibrin glue carefully. To prevent delamination of the membrane, make sure the Chondro-Gide® is flush with the edge of the defect.
References
- VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804) (Clinical study)
- JANELLI, E, et al. Arthroscopic treatment of chondral defects (Clinical study); in the hip: AMIC®, MACI, microfragmented adipose tissue transplantation (MATT) and other options. SICOT J, 2017, 3(43). www.sicot-org/articles/sicotj/abs/2017/01/sicotj170008/sicotj170008.html (Clinical study)
- Geistlich Pharma AG data on file (Bench test)
- GILLE, J., et al. Cell-Laden and Cell-Free Matrix-Induced-Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep. Cartilage OnlineFirst, January 7, 2010, doi:10.1177/1947603509358721 (Pre-clinical study)
- STEADMAN, J.R., Microfracture Technique for Full-Thickness Chondral Defects: Technique and Clinical Results. Operative Techniques in Orthopaedics. 1997. 7(4), 300-304. (Clinical study)
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