Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: technical description and a five pilot patients report

Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):536-42. doi: 10.1007/s00167-010-1337-4. Epub 2010 Dec 11.

Abstract

Purpose: This pilot study was designed to describe the technical details and to present the preliminary outcome of autologous matrix-induced chondrogenesis (AMIC) combined with platelet-rich plasma gel, the so called AMIC plus technique, for the treatment of patellar cartilage defects in the knee.

Methods: The AMIC plus technique was used for the treatment of (osteo) chondral patellar lesions in the knee. The surgical technique is extensively described. Five patients were clinically prospectively evaluated during 2 years. MRI data were analysed based on the original MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) and modified MOCART scoring system.

Results: A clinical improvement became apparent after 24 months of follow-up. Both MOCART scoring systems revealed no significant deterioration or improvement of the repair tissue between one and 2 years of follow-up. However, all cases showed subchondral lamina and bone changes. The formation of intralesional osteophytes was observed in 3 of the 5 patients during the 2 years of follow-up.

Conclusions: AMIC plus is feasible for the treatment of symptomatic patellar cartilage defects and resulted in a clinical improvement in all patients. The favourable clinical outcome of the AMIC plus technique was not confirmed by the MRI findings.

Level of evidence: IV.

MeSH terms

  • Adult
  • Cartilage, Articular / pathology
  • Cartilage, Articular / surgery*
  • Chondrogenesis / physiology
  • Collagen / pharmacology*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Gels / pharmacology
  • Humans
  • Knee Injuries / diagnosis
  • Knee Injuries / surgery
  • Male
  • Middle Aged
  • Pain Measurement
  • Patella / physiopathology
  • Pilot Projects
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Sampling Studies
  • Suture Techniques
  • Tissue Engineering / methods*
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult

Substances

  • Gels
  • Collagen