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AMIC® Chondro-Gide® nel ginocchio

Informazioni generali AMIC Chondro-Gide AMIC nel ginocchio AMIC nell’astragalo AMIC nell’anca Strumenti Artroscopici AMIC AMMR Video di chirurgia AMIC DataBank

Chondro-Gide 25 anni Chondro-Gide

AMIC® Chondro-Gide^®è una procedura minimamente invasiva a singolo step che usa la Condrogenesi Autologa Indotta da Matrice (AMIC®) combinata con Chondro-Gide® nella riparazione dei difetti cartilaginei. Supportata da più di 10 ani di successi clinici, AMIC® Chondro-Gide^®è un trattamento efficace e economico^1-3 per la riparazione della cartilagine danneggiata del ginocchio, alleviando o prevenendo il dolore e rallentando la progressione del danno.

AMIC® Chondro-Gide^®combina le Microfratture (MFx) con l’uso di Chondro-Gide^®che copre e protegge sia il coagulo proveniente dalle MFX che la riparazione tissutale⁴. Può essere fatta sia in chirurgia mini-open che in artroscopia. Biocompatibile e completamente riassorbibile, Chondro-Gide^®supporta il potenziale fisiologico di guarigione.

Vantaggi

Con la sua speciale stuttura doppio strato, Chondro-Gide® fornisce un ambiente protettivo che favorisce la crescita di nuovo tessuto^5,6.

Membrana di collagene naturale I/III doppio strato⁵
Biocompatibile e naturalmente riassorbibile⁵
Facile da maneggiare: flessibile e resistente alle lacerazioni⁵
Può essere stabilizzata con colla di fibrina in situ⁵
Compatibile con varie tecniche di rigenerazione tissutale⁷
Procedura one-step⁵
Pronta per l’uso⁵

References

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)
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)
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)
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)
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)

AMIC® Chondro-Gide® per la rigenerazione

Il riconoscimento precoce e trattamento con AMIC® Chondro-Gide® può alleviare o prevenire il dolore e rallenta la progressione del danno.

References

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)
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)
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)
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)
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)

01/05

Tecnica chirurgica in Mini-Open, Dr. M. Steinwachs

1. Mini-Open: preparazione del sito chirurgico

3. Mini-Open: adattamento della Chondro-Gide®

5. Mini-Open: rimozione del tessuto residuo

6. Mini-Open: Fissaggio di Chondro-Gide®

7. Mini-Open: Posizionamento e fissaggio di Chondro-Gide®

8. Mini-Open: Suturare al posto di Incollare

Esporre l’articolazione attraverso un approccio anteriore mini-invasivo standard. Rimuovere la cartilagine danneggiata e instabile con bisturi, curette e cucchiaio fino ad ottenere una spalla stabile e perpendicolare attorno al difetto.

References

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)
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)
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)
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)
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)

01/05

Tecnica chirurgia in artroscopia, prof. Dr. Justus Gille

1. Artroscopia: preparazione del sito chirurgico

2. Artroscopia: misura della dimensione del difetto

3. Artroscopia: preparazione della Chondro-Gide®

5. Artroscopia: Posizione di Chondro-Gide®

7. Artroscopia: Fissaggio di Chondro-Gide®

8. Artroscopia: Rimozione dell’eccesso di colla

Usare una curette affilata per rimuovere i frammenti di cartilagine e creare le pareti del difetto verticali lisce.

References

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)
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)
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)
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)
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)

01/05

Evidenza clinica su AMIC® nel ginocchio

AMIC® Chondro-Gide® si è dimostrata essere un trattamento efficace nella riparazione di lesioni cartilaginea nel ginocchio. Studi clinici mostrano il successo del trattamento con AMIC® Chondro-Gide^®sia con chirurgia mini-open che con tecniche artroscopiche per oltre 10 anni¹⁴.

Migliore performance rispetto alle sole Microfratture (MFx), dopo 2 anni

In uno studio controllato randomizzato a 3 gruppi con 47 pazienti in due centri¹⁵, è stata visto un significativo peggioramento del risultato dopo 2 anni dal trattamento con solo MicroFratture (MFx) (senza Chondro-Gide®). Sia il dolore che i valori funzionali (ICRS e Valori di Cincinnati modificati) rimanevano stabili o addirittura miglioravano con AMIC®, mentre dolore e valori funzionali peggioravano per il gruppo MFx.

References

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)
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)
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)
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)
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)

Stato funzionale nel tempo

AMIC® mostra una performance migliore rispetto alle sole MFx dopo 2 anni.

Artroscopia o mini-artrotomia, entrambe danno buoni risultati

In uno studio retrospettivo, Schagemann et al.¹⁶ hanno confrontato i risultati clinici delle procedure di AMIC® Chondro-Gide^®eseguite in artroscopia o chirurgia mini-open, in pazienti seguiti fino a 2 anni. In base alla ’ Visual Analog Scale' (VAS) dei pazienti, Lysholm scores, e Knee injury and Osteoarthrithis Outcome Scores (KOOS), entrambi gli approcci chirurgici hanno permesso di ottenere buoni risultati.

Prima Meta-analisi di 12 studi su AMIC® Chondro-Gide® su 375 pazienti

Recentemente (2019) in una revisione sistematica e meta-analisi sui risultati ottenuti con AMIC®, gli autori hanno valutato lesioni condrali e osteocondrali di grado III/IV nel ginocchio con una dimensione del difetto media di 4.24 cm² con più di 7 anni di follow-up.

L’uso della AMIC® Chondro-Gide^®per difetti di dimensione tale che siano sopra la soglia raccomandata per le MFx, riduce significativamente il dolore e migliora la funzione dal baseline al follow-up. La meta-analisi documenta che la procedura AMIC® Chondro-Gide^®migliora significativamente i risultati relativi a dolore e funzionalità nelle articolazioni del ginocchio con lesioni condrali o osteocondrali. I risultati inoltre dimostrano che il miglioramento è stato mantenuto per più di 5 anni, a conferma del successo a lungo termine della procedura AMIC® Chondro-Gide^®nelle lesioni maggiori di grado III (> 4 cm²) e di grado IV¹⁷.

ACI-C e AMIC® Chondro-Gide^®forniscono buoni risultati dopo 2 anni

Fossum et al. (2019) hanno condotto uno studio prospettico controllato randomizzato per valutare i risultati delle tecniche ACI-C e AMIC® nei difetti condrali e osteocondrali del femore distale e patella. Non ci sono differenze significative tra i risultati ottenuti con ACI-C e AMIC® a 1 e 2 anni.

Gli autori concludono che AMIC® può essere considerata un’alternativa a ACI-C sovrapponibile dal punto di vista clinico ma meno costosa in quanto AMIC® è a singolo step e quindi molto meno dispensiosa in termini di risorse18.

References

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)
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)
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)
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)
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)

Steven Kramer

International Product Manager Sports Medicine

ortho@geistlich.com

+41 41 492 53 75

Vantaggi

Tecnica chirurgica in Mini-Open, Dr. M. Steinwachs

Tecnica chirurgia in artroscopia, prof. Dr. Justus Gille

Evidenza clinica su AMIC® nel ginocchio

Migliore performance rispetto alle sole Microfratture (MFx), dopo 2 anni

Artroscopia o mini-artrotomia, entrambe danno buoni risultati

Prima Meta-analisi di 12 studi su AMIC® Chondro-Gide® su 375 pazienti

ACI-C e AMIC® Chondro-Gide® forniscono buoni risultati dopo 2 anni

ACI-C e AMIC® Chondro-Gide^®forniscono buoni risultati dopo 2 anni