Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 5/2017

01.11.2016 | Original Article • KNEE - ARTHROPLASTY

Combining a novel leucocyte–platelet-concentrated membrane and an injectable collagen scaffold in a single-step AMIC procedure to treat chondral lesions of the knee: a preliminary retrospective study

verfasst von: Corrado D’Antimo, Francesco Biggi, Alessio Borean, Stefano Di Fabio, Ivan Pirola

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Different surgical approaches are currently available to treat knee chondral defects. Microfracture is the most commonly applied, but it often leads to a mechanically inferior fibrocartilaginous tissue. To overcome this shortcoming, the Autologous, Matrix-Induced Chondrogenesis (AMIC) technique has been proposed. To further enhance the outcome of AMIC, the addition of haemoderivatives containing growth factors that stimulate cartilage healing has emerged as a new treatment method. Recently, a novel leucocyte–platelet-concentrated membrane (CLP-MB), highly enriched in platelets, monocytes/macrophages, fibrinogen, CD34+ and CD34+VEGFR-2+CD133+ cells, has been developed. Additionally, an injectable collagen scaffold (Cartifill) has been proposed as a replacement of the AMIC standard collagen membrane.

Aims

This preliminary study is aimed to evaluate the short-term safety and efficacy of the use of the CLP-MB membrane and injectable collagen scaffold when combined in single-step AMIC procedures for the treatment of knee chondral lesions.

Methods

Medical records of patients who underwent an AMIC procedure with the CLP-MB membrane combined with Cartifill were reviewed retrospectively. Follow-up assessments were conducted at 6 and 12 months after surgery. Clinical function was assessed on the basis of the International Knee Documentation Committee (IKDC) score. Pain was evaluated using the visual analogue scale (VAS).

Results

Twenty-five patients were identified as meeting the inclusion criteria. Mean IKDC and VAS scores significantly improved during the follow-up time. The postoperative course was uneventful.

Conclusions

AMIC combined with the CLP-MB membrane, and Cartifill seems to be a promising approach to treat knee chondral defects.
Literatur
1.
Zurück zum Zitat Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25,124 knee arthroscopies. Knee 14:177–182CrossRefPubMed Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25,124 knee arthroscopies. Knee 14:177–182CrossRefPubMed
2.
Zurück zum Zitat Vaquero J, Forriol F (2012) Knee chondral injuries: clinical treatment strategies and experimental models. Injury 43:694–705CrossRefPubMed Vaquero J, Forriol F (2012) Knee chondral injuries: clinical treatment strategies and experimental models. Injury 43:694–705CrossRefPubMed
3.
Zurück zum Zitat Erggelet C, Vavken P (2016) Microfracture for the treatment of cartilage defects in the knee joint—a golden standard? J Clin Orthop Trauma 7:145–152CrossRefPubMed Erggelet C, Vavken P (2016) Microfracture for the treatment of cartilage defects in the knee joint—a golden standard? J Clin Orthop Trauma 7:145–152CrossRefPubMed
7.
Zurück zum Zitat Caloprisco G, Borean A, De Angeli S et al (2010) New method to produce hemocomponents for regenerative use from peripheral blood: integration among platelet growth factors monocytes and stem cells. Transfus Apher Sci 42:117–124CrossRefPubMed Caloprisco G, Borean A, De Angeli S et al (2010) New method to produce hemocomponents for regenerative use from peripheral blood: integration among platelet growth factors monocytes and stem cells. Transfus Apher Sci 42:117–124CrossRefPubMed
8.
Zurück zum Zitat Steadman JR, Rodkey WG, Briggs KK (2002) Microfracture to treat full-thickness chondral defects: surgical technique, rehabilitation, and outcomes. J Knee Surg 15:170–176PubMed Steadman JR, Rodkey WG, Briggs KK (2002) Microfracture to treat full-thickness chondral defects: surgical technique, rehabilitation, and outcomes. J Knee Surg 15:170–176PubMed
9.
Zurück zum Zitat Hunziker EB, Lippuner K, Keel MJB, Shintani N (2015) An educational review of cartilage repair: precepts & practice–myths & misconceptions–progress & prospects. Osteoarthr Cartil 23:334–350CrossRefPubMed Hunziker EB, Lippuner K, Keel MJB, Shintani N (2015) An educational review of cartilage repair: precepts & practice–myths & misconceptions–progress & prospects. Osteoarthr Cartil 23:334–350CrossRefPubMed
10.
Zurück zum Zitat Bark S, Piontek T, Behrens P et al (2014) Enhanced microfracture techniques in cartilage knee surgery: fact or fiction? World J Orthop 5:444–449CrossRefPubMedPubMedCentral Bark S, Piontek T, Behrens P et al (2014) Enhanced microfracture techniques in cartilage knee surgery: fact or fiction? World J Orthop 5:444–449CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Gille J, Schuseil E, Wimmer J et al (2010) Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 18:1456–1464CrossRefPubMed Gille J, Schuseil E, Wimmer J et al (2010) Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 18:1456–1464CrossRefPubMed
12.
Zurück zum Zitat Kusano T, Jakob RP, Gautier E et al (2011) Treatment of isolated chondral and osteochondral defects in the knee by autologous matrix-induced chondrogenesis (AMIC). Knee Surg Sports Traumatol Arthrosc 20:2109–2115CrossRefPubMed Kusano T, Jakob RP, Gautier E et al (2011) Treatment of isolated chondral and osteochondral defects in the knee by autologous matrix-induced chondrogenesis (AMIC). Knee Surg Sports Traumatol Arthrosc 20:2109–2115CrossRefPubMed
13.
Zurück zum Zitat Anders S, Volz M, Frick H, Gellissen J (2013) A randomized, controlled trial comparing autologous matrix-induced chondrogenesis (AMIC®) to microfracture: analysis of 1- and 2-year follow-up data of 2 centers. Open Orthop J 7:133–143CrossRefPubMedPubMedCentral Anders S, Volz M, Frick H, Gellissen J (2013) A randomized, controlled trial comparing autologous matrix-induced chondrogenesis (AMIC®) to microfracture: analysis of 1- and 2-year follow-up data of 2 centers. Open Orthop J 7:133–143CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Wang Y, Yuan M, Guo Q et al (2015) Mesenchymal stem cells for treating articular cartilage defects and osteoarthritis. Cell Transplant 24:1661–1678CrossRefPubMed Wang Y, Yuan M, Guo Q et al (2015) Mesenchymal stem cells for treating articular cartilage defects and osteoarthritis. Cell Transplant 24:1661–1678CrossRefPubMed
15.
Zurück zum Zitat Chahla J, Dean CS, Moatshe G et al (2016) Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee. Orthop J Sports Med 4:2325967115625481PubMedPubMedCentral Chahla J, Dean CS, Moatshe G et al (2016) Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee. Orthop J Sports Med 4:2325967115625481PubMedPubMedCentral
16.
Zurück zum Zitat Enea D, Cecconi S, Calcagno S et al (2015) One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study. Knee 22:30–35CrossRefPubMed Enea D, Cecconi S, Calcagno S et al (2015) One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study. Knee 22:30–35CrossRefPubMed
17.
Zurück zum Zitat Enea D, Cecconi S, Calcagno S et al (2013) Single-stage cartilage repair in the knee with microfracture covered with a resorbable polymer-based matrix and autologous bone marrow concentrate. Knee 20:562–569CrossRefPubMed Enea D, Cecconi S, Calcagno S et al (2013) Single-stage cartilage repair in the knee with microfracture covered with a resorbable polymer-based matrix and autologous bone marrow concentrate. Knee 20:562–569CrossRefPubMed
18.
19.
Zurück zum Zitat Guney A, Akar M, Karaman I et al (2013) Clinical outcomes of platelet rich plasma (PRP) as an adjunct to microfracture surgery in osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 23:2384–2389CrossRefPubMed Guney A, Akar M, Karaman I et al (2013) Clinical outcomes of platelet rich plasma (PRP) as an adjunct to microfracture surgery in osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 23:2384–2389CrossRefPubMed
20.
Zurück zum Zitat Lee GW, Son J-H, Kim J-D, Jung G-H (2013) Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age? Eur J Orthop Surg Traumatol 23:581–587CrossRefPubMed Lee GW, Son J-H, Kim J-D, Jung G-H (2013) Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age? Eur J Orthop Surg Traumatol 23:581–587CrossRefPubMed
21.
Zurück zum Zitat Manunta AF, Manconi A (2013) The treatment of chondral lesions of the knee with the microfracture technique and platelet-rich plasma. Joints 1:167–170PubMed Manunta AF, Manconi A (2013) The treatment of chondral lesions of the knee with the microfracture technique and platelet-rich plasma. Joints 1:167–170PubMed
22.
Zurück zum Zitat Milano G, Sanna Passino E, Deriu L et al (2010) The effect of platelet rich plasma combined with microfractures on the treatment of chondral defects: an experimental study in a sheep model. Osteoarthr Cartil 18:971–980CrossRefPubMed Milano G, Sanna Passino E, Deriu L et al (2010) The effect of platelet rich plasma combined with microfractures on the treatment of chondral defects: an experimental study in a sheep model. Osteoarthr Cartil 18:971–980CrossRefPubMed
23.
Zurück zum Zitat Buda R, Vannini F, Cavallo M et al (2013) One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results. Musculoskelet Surg 97:145–151CrossRefPubMed Buda R, Vannini F, Cavallo M et al (2013) One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results. Musculoskelet Surg 97:145–151CrossRefPubMed
24.
Zurück zum Zitat Dhollander AAM, Neve FD, Almqvist KF et al (2010) Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report. Knee Surg Sports Traumatol Arthrosc 19:536–542CrossRefPubMed Dhollander AAM, Neve FD, Almqvist KF et al (2010) Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report. Knee Surg Sports Traumatol Arthrosc 19:536–542CrossRefPubMed
25.
Zurück zum Zitat Siclari A, Mascaro G, Kaps C, Boux E (2014) A 5-year follow-up after cartilage repair in the knee using a platelet-rich plasma-immersed polymer-based implant. Open Orthop J 8:346–354CrossRefPubMedPubMedCentral Siclari A, Mascaro G, Kaps C, Boux E (2014) A 5-year follow-up after cartilage repair in the knee using a platelet-rich plasma-immersed polymer-based implant. Open Orthop J 8:346–354CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Kim J, Cho H, Young K et al (2015) In vivo animal study and clinical outcomes of autologous atelocollagen-induced chondrogenesis for osteochondral lesion treatment. J Orthop Surg Res 10:82CrossRefPubMedPubMedCentral Kim J, Cho H, Young K et al (2015) In vivo animal study and clinical outcomes of autologous atelocollagen-induced chondrogenesis for osteochondral lesion treatment. J Orthop Surg Res 10:82CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Kuroda R, Matsumoto T, Kawakami Y et al (2014) Clinical impact of circulating CD34-positive cells on bone regeneration and healing. Tissue Eng Part B Rev 20:190–199CrossRefPubMedPubMedCentral Kuroda R, Matsumoto T, Kawakami Y et al (2014) Clinical impact of circulating CD34-positive cells on bone regeneration and healing. Tissue Eng Part B Rev 20:190–199CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Timmermans F, Plum J, Yöder MC et al (2009) Endothelial progenitor cells: identity defined? J Cell Mol Med 13:87–102CrossRefPubMed Timmermans F, Plum J, Yöder MC et al (2009) Endothelial progenitor cells: identity defined? J Cell Mol Med 13:87–102CrossRefPubMed
29.
Zurück zum Zitat Anghelina M, Krishnan P, Moldovan L, Moldovan NI (2006) Monocytes/macrophages cooperate with progenitor cells during neovascularization and tissue repair. Am J Pathol 168:529–541CrossRefPubMedPubMedCentral Anghelina M, Krishnan P, Moldovan L, Moldovan NI (2006) Monocytes/macrophages cooperate with progenitor cells during neovascularization and tissue repair. Am J Pathol 168:529–541CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Hopper N, Wardale J, Brooks R et al (2015) Peripheral blood mononuclear cells enhance cartilage repair in in vivo osteochondral defect model. PLoS ONE 10:e0133937CrossRefPubMedPubMedCentral Hopper N, Wardale J, Brooks R et al (2015) Peripheral blood mononuclear cells enhance cartilage repair in in vivo osteochondral defect model. PLoS ONE 10:e0133937CrossRefPubMedPubMedCentral
Metadaten
Titel
Combining a novel leucocyte–platelet-concentrated membrane and an injectable collagen scaffold in a single-step AMIC procedure to treat chondral lesions of the knee: a preliminary retrospective study
verfasst von
Corrado D’Antimo
Francesco Biggi
Alessio Borean
Stefano Di Fabio
Ivan Pirola
Publikationsdatum
01.11.2016
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2017
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-016-1869-5

Weitere Artikel der Ausgabe 5/2017

European Journal of Orthopaedic Surgery & Traumatology 5/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.