Nanofractured autologous matrix induced chondrogenesis (NAMIC©) — Further development of collagen membrane aided chondrogenesis combined with subchondral needling

Benthien, Jan Philipp; Behrens, P.

doi:10.1016/j.knee.2015.06.010

Cited by 27 publications

(15 citation statements)

References 17 publications

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“…With the use of microfractures, chondrogenic cells (MSCs) migrate into the fibrin network of the blood clot. However, the fibrin clot is not very stable (Benthien and Behrens 2010, 2015). An implanted covering scaffold (e.g.…”

Section: Methodsmentioning

confidence: 99%

Cartilage repair in the degenerative ageing knee

et al. 2016

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Background and purposeCartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence.Results and interpretationBased on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints.

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Section: Methodsmentioning

confidence: 99%

Cartilage repair in the degenerative ageing knee

et al. 2016

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“…However, due to its abundance and versatility, collagen I (rather than type II) is usually used [369]. Collagen scaffolds have also been used in clinical trials immediately after microfracture treatment, although assessment of the benefit of this treatment still requires further analysis [370,371,372]. Multi-layered collagen scaffolds, which can more effectively mimic the zonal structure of articular cartilage, have also been recently examined in large animal models [373,374].…”

Section: Biomaterialsmentioning

confidence: 99%

The Good the Bad and the Ugly of Glycosaminoglycans in Tissue Engineering Applications

2017

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High sulfation, low cost, and the status of heparin as an already FDA- and EMA- approved product, mean that its inclusion in tissue engineering (TE) strategies is becoming increasingly popular. However, the use of heparin may represent a naïve approach. This is because tissue formation is a highly orchestrated process, involving the temporal expression of numerous growth factors and complex signaling networks. While heparin may enhance the retention and activity of certain growth factors under particular conditions, its binding ‘promiscuity’ means that it may also inhibit other factors that, for example, play an important role in tissue maintenance and repair. Within this review we focus on articular cartilage, highlighting the complexities and highly regulated processes that are involved in its formation, and the challenges that exist in trying to effectively engineer this tissue. Here we discuss the opportunities that glycosaminoglycans (GAGs) may provide in advancing this important area of regenerative medicine, placing emphasis on the need to move away from the common use of heparin, and instead focus research towards the utility of specific GAG preparations that are able to modulate the activity of growth factors in a more controlled and defined manner, with less off-target effects.

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“…Generally, nanofractures technique is preferred, with standardized drilled holes nine millimeters deep and one millimeter in diameter and standard needle angling [20][21][22]. All-arthroscopic techniques have been described as well [22][23][24]. The collagen matrix of choice is consequently trimmed to fill the size of the defect, usually by template or imprint.…”

Section: Surgical Techniquementioning

confidence: 99%

Management of Knee Cartilage Defects with the Autologous Matrix-Induced Chondrogenesis (AMIC) Technique

Hantes¹,

Fyllos²

2018

Cartilage Repair and Regeneration

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The arthroscopic findings of knee articular cartilage lesions are reported to be as high as 60%, although only a fragment of these are considered to be symptomatic. Such lesions are believed to accelerate the onset of arthritis. Long-term results of the microfracture technique for chondral and osteochondral defects of the knee cartilage are not satisfactory. The autologous matrix induced chondrogenesis (AMIC) technique offers a promising alternative as an effective cartilage repair procedure in the knee resulting in stable clinical results and with a wide range of indications. An extensive literature review has been performed aiming at providing the rationale behind AMIC, to report clinical results of AMIC and to compare AMIC with other chondrogenesis techniques. Finally, we comment on the appropriate surgical technique and its indications, since the number of onestep arthroscopic procedure proposals is steadily increasing.

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Nanofractured autologous matrix induced chondrogenesis (NAMIC©) — Further development of collagen membrane aided chondrogenesis combined with subchondral needling

Cited by 27 publications

References 17 publications

Cartilage repair in the degenerative ageing knee

Cartilage repair in the degenerative ageing knee

The Good the Bad and the Ugly of Glycosaminoglycans in Tissue Engineering Applications

Management of Knee Cartilage Defects with the Autologous Matrix-Induced Chondrogenesis (AMIC) Technique

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