AMIC® Chondro-Gide® in the Talus

Chondral and Osteochondral Lesions (OCL) of the ankle are common and increasingly recognized sources of persistent ankle pain. Most osteochondral lesions of the talus (OLTs) are due to trauma and repetitive microtrauma.1 About 50% of ankle sprains and up to 73% of ankle fractures result in cartilage injury and can cause symptoms.2

 

Bone Marrow Stimulation Recommended for OCL <1 cm2

Ramponi et. al.3 recommended that bone marrow stimulation techniques should be reserved for OCL < 1 cm2. The 1 cm2 threshold was also supported during a 2017 consensus meeting of the International Society on Cartilage Repair of the Ankle (ISCRA). To view these and other consensus statements, visit the ON Foundation website.

ISCRA defined the ideal size guidelines for bone marrow stimulation as a diameter of < 10 mm, an area of < 100 mm2, and a depth of < 5 mm.4  Bone grafting may be considered for a depth of > 3 mm. Based on current literature, the consensus recommendation supports the use of a scaffold to complement bone grafting.5

 

AMIC® Chondro-Gide® for Effective Cartilage Repair

AMIC® Chondro-Gide® is a minimally-invasive 1-step procedure that uses  bone marrow stimulation combined with Chondro-Gide to repair cartilage defects of all sizes. It can be performed either by osteotomyor mini-open surgery7.

Developed by Geistlich Surgery in collaboration with leading surgeons in Europe,  AMIC® Chondro-Gide® is an effective and cost-effective treatment7  for repairing damaged cartilage , alleviating or preventing pain, and slowing the progression of damage.

 

 

Mini - Open Technique described by Dr. Markus Walther

 

 

Sugical Videos

 

References

  1. CHEW, K. T. L., 2008, Osteochondral lesions of the talus. Annals of the Academy of Medicine. 2008. Vol.37, no. 1, p. 63-8
  2. STEELE, J. R., et al., Osteochondral Lesions of the Talus. Foot & Ankle Orthopaedics. 2018. Vol. 3, no. 3, p. 247301141877955. DOI 10.1177/2473011418779559. SAGE Publications
  3. RAMPONI, L., et al., Lesion Size Is a Predictor of Clinical Outcomes After Bone Marrow Stimulation for Osteochondral Lesions of the Talus: A Systematic Review. The American Journal of Sports Medicine. 2016. Vol. 45, no. 7, p. 1698-1705. DOI10.1177/0363546516668292. SAGE Publications (Systematic Review)
  4. HANNON et al. Debridement, Curettage, Microfracture, and Fixation Techniques for Osteochondral Lesions of the Talus, 2018. Foot & Ankle Orthopaedics, Vol. 3, no. 3, p. 2473011418S0006. DOI 10.1177/2473011418s00066. SAGE Publications (Consensus Meeting Report)
  5. ROTHRAUFF, B.B., et al., Scaffold-Based Therapies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle. Foot & Ankle International. 2018. Vol. 39, no. 1_suppl, p. 41S-47S. DOI 10.1177/1071100718781864. SAGE Publications (Consensus Meeting)24. WALTHER, M., ALTENBERGER, S., KRIEGELSTEIN, S., VOLKERING, C. and R.SER, A., 2014, Reconstruction of focal cartilage defects in the talus with miniarthrotomy and collagen matrix. Operative Orthop.die und Traumatologie. 2014. Vol. 26, no. 6, p. 603-610. DOI 10.1007/s00064-012-0229-9. Springer Nature (Clinical Study)
  6. VALDERRABANO, V., et al., Reconstruction of Osteochondral Lesions of the Talus With Autologous Spongiosa Grafts and Autologous Matrix-Induced Chondrogenesis. The American Journal of Sports Medicine. 2013. Vol. 41, no. 3, p. 519-527.DOI 10.1177/0363546513476671. SAGE Publications (Clinical Study)
  7. WALTHER, M., et al., Reconstruction of focal cartilage defects in the talus with miniarthrotomy and collagen matrix. Operative Orthop.die und Traumatologie. 2014. Vol. 26, no. 6, p. 603-610. DOI 10.1007/s00064-012-0229-9. Springer Nature (Clinical Study)
  8. GOTTSCHALK, O., et al., Functional Medium-Term Results After Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A 5-Year Prospective Cohort Study. The Journalof Foot and Ankle Surgery. 2017. Vol. 56, no. 5, p. 930-936. DOI 10.1053/j.jfas.2017.05.002. Elsevier BV (Clinical Study)
  9. YOUNG, KI WON, et al., Medial approaches to osteochondral lesion of the talus without medial malleolar osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy. 2009. Vol. 18, no. 5, p. 634-637. DOI 10.1007/s00167-009-1019-2. Springer Nature
  10. GALLA, MELLANY, DUENSING, IAN, KAHN, TIMOTHY L. and BARG, ALEXEJ, 2018, Open reconstruction with autologous spongiosa grafts and matrix-induced chondrogenesis for osteochondral lesions of the talus can be performed without medial malleolar osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy. 2018. DOI 10.1007/s00167-018-5063-7. Springer Nature (Clinical Study)

 

Dr. Sanja Saftic
International Product Manager