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

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2011-04, Vol.19 (4), p.536-542
• Main Authors: Dhollander, A. A. M., De Neve, F., Almqvist, K. F., Verdonk, R., Lambrecht, S., Elewaut, D., Verbruggen, G., Verdonk, P. C. M.
• Format: Article
• Language: English
• Subjects: Adult; Arthritis; arthroscopy; Blood; Bone (subchondral); Bone marrow; Bones; Cartilage; Cartilage, Articular - pathology; Cartilage, Articular - surgery; Chondrogenesis; Chondrogenesis - physiology; Collagen; Collagen - pharmacology; Combined Modality Therapy; Data processing; Defects; Female; Follow-Up Studies; Gels - pharmacology; Hospitals; Humans; Knee; Knee Injuries - diagnosis; Knee Injuries - surgery; Knees; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Middle Aged; N.M.R; Orthopedics; Osteoarthritis; osteophytes; Pain Measurement; Patella - physiopathology; Patients; Pilot Projects; Plasma; Platelet-Rich Plasma; Prospective Studies; Sampling Studies; scoring; Sports; Surgery; Suture Techniques; Sutures; Techniques; Tissue Engineering - methods; Transplantation, Autologous; Treatment Outcome; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-010-1337-4

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.