Clinical Evidence – AMIC® Chondro-Gide® in the Talus

How Chondro-Gide® Works

Chondro-Gide® provides a protective cover and keeps in place cells released from the bone or introduced into a defect. It complements regenerative treatment approaches for chondral and osteochondral lesions. While enveloping the defect and the cells within it during the initial stages of the healing process, Chondro-Gide® resorbs over approximately 1- 4 months1 and is replaced by native tissue.

Chondro-Gide® Successful without Osteotomy

Several studies have shown that Chondro-Gide® can be successfully introduced and placed without osteotomy. Walther et al.2 described the reconstruction of focal cartilage defects in the talus with mini-arthrotomy and Chondro-Gide for ICRS grade III and IV focal cartilage defects of an area of > 1.5 cm2. The researchers reviewed postoperative results of 14 patients for a follow-up period of > 30 months. All showed improved American Orthopedic Foot and Ankle Society (AOFAS) scores, from 50 to 89 points, with equal mobility on both sides of the upper ankle joint. They observed no intraoperative complications. They concluded that AMIC® Chondro-Gide® is a simple procedure. The membrane can be implanted via mini-arthrotomy alone, without osteotomy of the lateral or medial malleolus in almost all cases. They also considered AMIC® Chondro-Gide® to be a cost-efficient 1-step procedure compared to cartilage  reconstruction with in-vitro cultured chondrocytes.

In an analysis of mid-term results, Gottschalk et al.3 found promising results in both 2- and 5-year studies of the patient cohort. The researchers found the greatest improvement in clinical outcomes in the first year post operation. Between the 1- and 5-year follow-up further, but statistically nonsignificant improvement could be observed. Significantly, patients returned to sports at 5 years.

 

 

 

Several authors have reported the advantage of an arthroscopic procedure for the treatment of OCL of the talus. Arthroscopic treatment can reduce surgical trauma, and makes a tibial or fibular osteotomy and subsequent hardware removal unnecessary.4

For more details on Chondro-Gide®, surgical techniques, and clinical insights, download the brochure.

 

References

  1. Chondro-Gide® IFU 2019, Geistlich Pharma AG
  2. WALTHER, M., et al., Reconstruction of focal cartilage defects in the talus with miniarthrotomy and collagen matrix. Operative Orthopädie und Traumatologie. 2014. Vol. 26, no. 6, p. 603-610. DOI 10.1007/s00064-012-0229-9. Springer Nature (Clinical Study)
  3. 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 Journal of Foot and Ankle Surgery. 2017. Vol. 56, no. 5, p. 930-936. DOI 10.1053/j.jfas.2017.05.002. Elsevier BV (Clinical Study)
  4. USUELLI, F., et al., All-arthroscopic AMIC® (AT-AMIC®) technique with autologous bone graft for talar osteochondral defects: clinical and radiological results. Knee Surgery, Sports Traumatology, Arthroscopy. 2016. Vol. 26, no. 3, p. 875-881. DOI 10.1007/s00167-016-4318-4. Springer Nature (Clinical Study)

 

Dr. Sanja Saftic
International Product Manager