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All-Arthroscopic Technique to Repair Knee Cartilage Defects Using the Autologous Matrix-Induced Chondrogenesis
| Content Provider | Semantic Scholar |
|---|---|
| Author | Piontek, Tomasz Ciemniewska-Gorzela, Kinga Szulc, Andrzej Naczk, Jakub Trzaska, Tadeusz |
| Copyright Year | 2013 |
| Abstract | One of the most promising fields of medical scientific research is regenerative medicine. Its major tools include both isolated cells and specially designed biomaterials. Bone marrow cells were introduced into clinical practice much earlier than other cell types due to their ability to differentiate into many types of cells. In fact, bone marrow mesenchymal stem cells are considered to be an attractive source of cells for the regeneration of tissues and organs, including articular surface cartilage. The simplest method for utilising stem cells in the regeneration of a damaged cartilage layer is the microfracture technique. Autologous Matrix-Induced Chondrogenesis (AMIC) is a variant of the microfracture method that utilises a collagen matrix to serve as a scaffold for new cells, allowing effective reconstruction of even large fragments of a damaged cartilage surface. Currently, such procedures are performed by means of surgically opening the knee joint. The goal of this article is to present an results of arthroscopic technique for reconstructing damaged knee cartilage fragments using the AMIC technique in conjunction with a collagen matrix and fibrin glue and present results of treatment. Material and Methods: Indications for cartilage reconstruction included International Cartilage Repair Society grade IV symptomatic damage of the burdened knee cartilage surface. The defect area was between 1,5 and 6 cm2. All surgical procedures were performed by a single surgeon (by the first author). The first part of the procedure is diagnostic knee arthroscopy. After complete inspection of the joints and assessment of the defects, the chondral lesions are carefully debrided down to the subchondral bone with a curette, spoon, and shaver until a stable shoulder surrounded the defect. Next, the size of each defect was assessed by a circular sharp punch. Corresponding numbers of circles are cut (with the same knives) in the collagen matrix after being moistened with physiological saline. The second part of the procedure is performed under dry arthroscopic conditions. According to recommendations specific to this method, numerous bores are drilled at 5-mm intervals in the subchondral layer with a 1.1-mm K-wire. Next, Chondro-Gide matrix circles of corresponding diameters are placed in the reconstruction area with pean clamps. The circular patches overlap. According to the original technique, the porous surface of the membrane is facing the bone surface. Fibrin glue is applied to all membrane-covered areas. Next, excess glue is separated from the surrounding soft tissue, and the glue is left for 5 minutes to set. Then, 10 knee movements (consisting of flexion and extension) are performed to check the stability of the reconstructed cartilage surface. International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine 9 th Biennial ISAKOS Congress • May 12-16, 2013 • Toronto, Canada ISAKOS |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.arthro.2013.07.175 |
| Alternate Webpage(s) | https://www.isakos.com/assets/globallink/2013congress/Abstracts/170_Piontek.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/j.arthro.2013.07.175 |
| Volume Number | 29 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
