AMIC® Chondro-Gide® is a minimally invasive 1-step treatment that uses Autologous Matrix-Induced Chondrogenesis (AMIC®) combined with Chondro-Gide® to repair cartilage defects of all sizes. Backed by more than 10 years of clinical success, AMIC® Chondro-Gide® is an effective and cost-effective treatment1,2,3 for repairing damaged knee cartilage, alleviating or preventing pain, and slowing the progression of damage.
AMIC® Chondro-Gide®combines microfracturing (MFx) with the use of Chondro-Gide®, which covers and protects both the super clot resulting from MFx and the repair tissue.4 It can be performed either by mini-open or arthroscopic methods. Biocompatible and fully resorbable, Chondro-Gide® supports the body’s own healing potential.
With its specially designed bilayer structure, Chondro-Gide® provides a protective environment that fosters the growth of new tissue.5,6
Bio-derived, bilayer Collagen I/III membrane5
Biocompatible and naturally resorbed5
Easy to handle: supple and tear-resistant5
Can be glued into place5
Compatible with a range of tissue regeneration techniques7
Using a standard, minimally invasive anterior approach, open the knee joint. Remove damaged and unstable cartilage with a scalpel, curette, and spoon 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.13 With adequate cooling, antegrade drilling is also possible.
Place the Chondro-Gide® into the defect with the rough (bottom) layer facing the bone surface. 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.
Once the Chondro-Gide® has been cut, moistened, and is inside the joint, distinguishing the smooth from the rough layer might be difficult. Use a sterile pen to lightly mark the smooth (top) layer of the Chondro-Gide® that will face the joint cavity. 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.
Using a 1.2 mm K-wire, perforate the subchondral bone at the base of the lesion. Working from the periphery of the lesion towards the center, insert holes at intervals of 3-4 mm13. With a shaver, carefully remove tissue fragments. Alternatively, use an awl or nanofracturing to perforate the subchondral bone.
With a probe or a shaver, remove the excess ﬁbrin glue.
Mini-Open AMIC Chondro-Gide in the Knee – Dr. M. Steinwachs
AMIC Chondro-Gide in the knee, mini-open technique performed by Dr. Matthias Steinwachs, Switzerland.
Arthroscopic AMIC Chondro-Gide in the Knee Dr. T. Piontek
Arthroscopic AMIC® Chondro-Gide® in the knee, with multiple pieces of Chondro-Gide®, performed by MD PhD Tomasz Piontek,Poland.
Arthroscopic AMIC Chondro-Gide in the knee, Dr. J. Gille, Germany.
Arthroscopic AMIC® Chondro-Gide® in the knee - Arthroscopy with 1 piece of Chondro-Gide®, performed by Prof. Dr. Justus Gille, Germany.
Animaton AMIC Chondro-Gide in the Knee
SCHIAVONE PANNI, A., et al. Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc, 2018 Apr 26(4):1130-36 (Clinical study)
WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
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)
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)
KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
MITHOEFER, K., et al. The microfracture technique for the sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
GOYAL, D., et al. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy, Sep 2013, 29(9), 1579-1588. (Review of clinical studies)
FONTANA, A., et al. Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment. Bone Joint J, May 2015, 97-B(5), 628-635. (Clinical study)
GAO, L., et al. Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair. Nature Scientif-ic Reports, 2017, 7:45189, DOI: 10.1038/srep45189 (Pre-clinical study)
FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
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)