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.
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.


OBJECTIVE
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.
Orthopaedics and Traumatology Department, San Martino Hospital, Belluno, Italy. corrado.dantimo@virgilio.it.
Corrado
http://orcid.org/0000-0002-4203-9443
C
D'Antimo
Orthopaedics and Traumatology Department, San Martino Hospital, Belluno, Italy.
Francesco
F
Biggi
Immunohematology and Transfusion Medicine Department, San Martino Hospital, Belluno, Italy.
Alessio
A
Borean
Orthopaedics and Traumatology Department, San Martino Hospital, Belluno, Italy.
Stefano
S
Di Fabio
Immunohematology and Transfusion Medicine Department, San Martino Hospital, Belluno, Italy.
Ivan
I
Pirola
D000071916:AC133 Antigen / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D001792:Blood Platelets; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D020219:Chondrogenesis; D003094:Collagen / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000503:physiopathology*; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008567:Membranes, Artificial; D009000:Monocytes / Q000378:metabolism; D010147:Pain Measurement; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism; D055815:Young Adult
D000071916:AC133 Antigen; D018952:Antigens, CD34; D008567:Membranes, Artificial; D005340:Fibrinogen; D003094:Collagen; C000588866:KDR protein, human; D040301:Vascular Endothelial Growth Factor Receptor-2
AMIC procedure; Cartifill; Haemoderivatives; Knee chondral defects; Leucocyte–platelet-concentrated membrane