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AMIC® Chondro-Gide® in the Knee

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. It can be performed either by mini-open or arthroscopic methods. Biocompatible and fully resorbable, Chondro-Gide® supports the body’s own healing potential.

Benefits

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
  • One-step procedure5
  • Ready for use off the shelf5

References

  1. 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)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. 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)
  5. Geistlich Pharma AG data on file (Bench test)
  6. 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)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. 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)
  9. 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)
  10. 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)
  11. 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)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. 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)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. 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)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)

Mini-Open Surgical Technique, Dr. M. Steinwachs

Arthroscopic Surgical Technique, Prof. Dr. Justus Gille

Surgical Videos

Clinical Evidence AMIC® Knee

AMIC® Chondro-Gide® has been shown to be an effective treatment to repair cartilage lesions of all sizes in the knee. Clinical studies show successful treatment using AMIC® Chondro-Gide® with both mini-open and arthroscopic techniques for more than 10 years.14

Better Performance than MFx Alone, After 2 Years

In a randomized, controlled 3-arm study of 47 patients in 2 centers15, a significant deterioration in results was seen after 2 years following MFx alone (without Chondro-Gide®). Pain and function scores (ICRS and modified Cincinnati scores) remained stable or even improved with AMIC®, while pain and function scores for the MFx group decreased.

References

  1. 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)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. 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)
  5. Geistlich Pharma AG data on file (Bench test)
  6. 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)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. 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)
  9. 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)
  10. 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)
  11. 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)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. 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)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. 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)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)
Functional Status Over Time
AMIC® Shows Better Performance than MFx Alone After 2 Years.

Arthroscopic or Mini-Arthrotomy, both Give Equally Good Results

In a retrospective study, Schagemann et al.16 compared the clinical outcomes of AMIC® Chondro-Gide® procedures that were performed as arthroscopic or mini-open surgeries. The study followed patients up to 2 years. According to the patients’ Visual Analog Scale (VAS), Lysholm scores, and Knee injury and Osteoarthrithis Outcome Scores (KOOS), both surgical approaches yielded equally positive results.

First Meta-Analysis of 12 AMIC® Chondro-Gide® Studies Including 375 Patients

Most recently, (2019) in a systematic review and meta-analysis of AMIC® outcomes, the authors evaluated grade III/IV chondral and osteochondral lesions in the knee with a mean defect size of 4.24 cm2 with up to 7 years follow-up.

The use of AMIC® Chondro-Gide® in defect sizes, which are above the recommended threshold for MFx, significantly reduced pain and improved function from baseline to follow-up.  The meta-analysis documents that the AMIC® Chondro-Gide® procedure significantly improves pain and functional outcomes in knee joints with chondral or osteochondral lesions. The results further demonstrate that the improvement was maintained over more than 5 years, which confirms the long-term success of AMIC® Chondro-Gide® in larger (>4 cm2) grade III and IV lesions.17

ACI-C and AMIC® Chondro-Gide® provide equally good results after 2 years 

Fossum, et al., (2019) conducted a prospective, randomized, controlled study to assess the  outcomes of ACI-C and AMIC® in chondral and osteochondral defects of the distal femur and patella. No significant differences were seen between the outcomes of the ACI-C and AMIC® techniques at 1 and 2 years.

The authors concluded that AMIC® could be considered a clinically equal, but less expensive alternative to ACI-C, as AMIC® is a 1-step procedure therefore far less resource-intensive.18

References

  1. 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)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. 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)
  5. Geistlich Pharma AG data on file (Bench test)
  6. 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)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. 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)
  9. 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)
  10. 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)
  11. 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)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. 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)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. 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)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)
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