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

Eur J Orthop Surg Traumatol. 2017 Jul;27(5):673-681. doi: 10.1007/s00590-016-1869-5. Epub 2016 Nov 1.

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.

Keywords: AMIC procedure; Cartifill; Haemoderivatives; Knee chondral defects; Leucocyte–platelet-concentrated membrane.

MeSH terms

  • AC133 Antigen / metabolism
  • Adolescent
  • Adult
  • Antigens, CD34 / metabolism
  • Blood Platelets
  • Cartilage, Articular / injuries
  • Cartilage, Articular / surgery*
  • Chondrogenesis
  • Collagen / administration & dosage
  • Collagen / therapeutic use*
  • Female
  • Fibrinogen / metabolism
  • Humans
  • Injections, Intra-Articular
  • Knee Joint / physiopathology*
  • Macrophages / metabolism
  • Male
  • Membranes, Artificial*
  • Monocytes / metabolism
  • Pain Measurement
  • Retrospective Studies
  • Tissue Scaffolds*
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism
  • Young Adult

Substances

  • AC133 Antigen
  • Antigens, CD34
  • Membranes, Artificial
  • Fibrinogen
  • Collagen
  • KDR protein, human
  • Vascular Endothelial Growth Factor Receptor-2