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AMIC® Chondro-Gide® Joelho

AMIC® Chondro-Gide® é um tratamento minimamente invasivo realizado em um único tempo cirúrgico que utiliza Condrogênse Autóloga Induzida por Matriz (AMIC®) em combinação com Chondro-Gide® para reparar lesões de cartilagem de todos os tamanhos. Respaldado por mais de 10 anos de sucesso clínico, AMIC® Chondro-Gide® é um tratamento eficiente e de excelente custo-benefício para reparar a cartilagem do joelho danificada, aliviando ou prevenindo a dor, e retardando a progressão da lesão.

AMIC® Chondro-Gide® combina estimulação medular com o uso de Chondro-Gide®, o qual recobre e protege ambos o super coágulo resultante da estimuação medular e o tecido de regeneração. O procedimento pode ser realizado através de uma mini-artrotomia ou por via artroscópica. Biocompatível e completamente reabsorvível, Chondro-Gide® potencializa a capacidade de cura do próprio corpo.

Benefícios

Com sua estrutura de dupla face especialmente fabricada, Chondro-Gide® proporciona um ambiente protetor que nutre o crescimento de um novo tecido.5 Membrana de colágeno tipo I/III,Bio-derivada.1

  • Membrana de colágeno tipo I/III,Bio-derivada 5
  • Biocompatível e naturalmente reabsorvida5
  • Fácil manuseio: flexível e resistente5
  • Pode ser fixada com cola de fibrina5
  • Compatível com diversas técnicas de regeneração de cartilagem7
  • Procedimento realizado em um único tempo cirúrgico5
  • Pronto para uso, estéril5

References

  1. SCHIAVONE PANNI, A., et al. Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc, 2018 Apr 26(4):1130-36 (Clinical study)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  5. Geistlich Pharma AG data on file (Bench test)
  6. GILLE, J., et al. Cell-Laden and Cell-Free Matrix-Induced-Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep. Cartilage OnlineFirst, January 7, 2010, doi:10.1177/1947603509358721 (Pre-clinical study)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. MITHOEFER, K., et al. The microfracture technique for the sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  9. GOYAL, D., et al. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy, Sep 2013, 29(9), 1579-1588. (Review of clinical studies)
  10. FONTANA, A., et al. Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment. Bone Joint J, May 2015, 97-B(5), 628-635. (Clinical study)
  11. GAO, L., et al. Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair.  Nature Scientif-ic Reports, 2017, 7:45189, DOI: 10.1038/srep45189 (Pre-clinical study)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. STEADMAN, J.R., Microfracture Technique for Full-Thickness Chondral Defects: Technique and Clinical Results. Operative Techniques in Orthopaedics. 1997. 7(4), 300-304. (Clinical study)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)

Técnica cirúrgica com Mini-Artrotomia, Dr. M. Steinwachs

Técnica Cirúrgica Artroscópica, Prof. Dr. Justus Gille

Vídeos Cirúrgicos

Evidências científicas AMIC® Joelho

AMIC® Chondro-Gide® demonstrou ser um tratamento eficaz para tratar lesões de cartilagem de todos os tamanhos no joelho. Estudos clínicos demonstram eficácia utilizando AMIC® Chondro-Gide®  com ambas as técnicas: mini-artrotomia ou artroscopia por mais de 10 anos.14

Resultado superior à Micro fratura, Após 2 anos

Em um estudo randomizado, controlado, de 47 pacientes em 2 centros, uma deterioração significante foi verificada após 2 anos de follow-up com micro fraturas (sem Chondro-Gide®). Os escores de dor e funcional (ICRS e Cincinnati) permaneceram estáveis ou até mesmo melhoraram com AMIC®, enquanto os escores de dor e funcional para o grupo de micro fraturas apresentou piora nos resultados.

References

  1. SCHIAVONE PANNI, A., et al. Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc, 2018 Apr 26(4):1130-36 (Clinical study)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  5. Geistlich Pharma AG data on file (Bench test)
  6. GILLE, J., et al. Cell-Laden and Cell-Free Matrix-Induced-Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep. Cartilage OnlineFirst, January 7, 2010, doi:10.1177/1947603509358721 (Pre-clinical study)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. MITHOEFER, K., et al. The microfracture technique for the sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  9. GOYAL, D., et al. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy, Sep 2013, 29(9), 1579-1588. (Review of clinical studies)
  10. FONTANA, A., et al. Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment. Bone Joint J, May 2015, 97-B(5), 628-635. (Clinical study)
  11. GAO, L., et al. Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair.  Nature Scientif-ic Reports, 2017, 7:45189, DOI: 10.1038/srep45189 (Pre-clinical study)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. STEADMAN, J.R., Microfracture Technique for Full-Thickness Chondral Defects: Technique and Clinical Results. Operative Techniques in Orthopaedics. 1997. 7(4), 300-304. (Clinical study)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)
Status Funcional ao Longo do Tempo
AMIC® demonstra resultado superior à micro fraturas isoladas, após 2 anos.

Artroscópica ou Mini-Artrotomia, ambas dão igualmente bons resultados

Em um estudo retrospectivo, Schagemann et al.16 compararam os resultados clínicos dos procedimentos AMIC® Chondro-Gide® que foram realizados como cirurgias artroscópicas ou mini-cirurgias abertas. O estudo acompanhou pacientes por até 2 anos. De acordo com a Visual Analog Scale (VAS) dos pacientes, escores Lysholm e Knee injury and Osteoarthrithis Outcome Scores (KOOS), ambas as abordagens cirúrgicas produziram resultados igualmente positivos.

Primeira Meta-Análise de 12 estudos AMIC® Chondro-Gide® incluindo 375 Pacientes

Recentemente, (2019) em uma revisão sistemática e meta-análise dos resultados de AMIC®, os autores avaliaram lesões condrais e osteocondrais grus III/IV no joelho com um tamanho médio de lesão de 4.24 cm2 com um follow-up superior a 7 anos.

A utilização de AMIC® Chondro-Gide® nos tamanhos de lesões, que estão acima do limite recomendado para micro fraturas, reduziram significativamente dor e melhoraram a função do início ao follow-up. A meta-análise registra que o procedimento AMIC® Chondro-Gide® melhora significativamente resultados funcionais e de dor nas articulações dos joelhos acometidos por lesões condrais e osteocondrais. Os resultados demonstraram que a melhora foi mantida acima de 5 anos, o que confirma o sucesso de longo prazo de AMIC® Chondro-Gide® em lesões grandes, acima de 4 cm2, grau III e IV.17

ACI-C e AMIC® Chondro-Gide® fornecem bons resultados após 2 anos

Fossum, et al., (2019) conduziu um estudo prospectivo, randomizado, controlado para avaliar os resultados de ACI-C e AMIC® em defeitos condrais e osteocondrais no fêmur distal e patela. Não foram verificadas diferenças significativas entre os resultados de ACI-C e AMIC® nos períodos de 1 ano e 2 anos.

Os autores concluiram que AMIC® pode ser considerado uma alternativa clinicamente igual, porém mais barata ao ACI-C, devido ao AMIC® ser realizado em um único procedimento cirúrgico.18

References

  1. SCHIAVONE PANNI, A., et al. Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc, 2018 Apr 26(4):1130-36 (Clinical study)
  2. WALTHER, M., et al. Scaffold based reconstruction of focal full thickness talar cartilage defects. Clinical Research on Foot & Ankle, 2013, 1-5. (Clinical study)
  3. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  4. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  5. Geistlich Pharma AG data on file (Bench test)
  6. GILLE, J., et al. Cell-Laden and Cell-Free Matrix-Induced-Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep. Cartilage OnlineFirst, January 7, 2010, doi:10.1177/1947603509358721 (Pre-clinical study)
  7. KRAMER, J., et al. In vivo matrix-guided human mesenchymal stem cells. Cell Mol Life Sci, Mar 2006, 63(5), 616-626. (Clinical study)
  8. MITHOEFER, K., et al. The microfracture technique for the sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  9. GOYAL, D., et al. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy, Sep 2013, 29(9), 1579-1588. (Review of clinical studies)
  10. FONTANA, A., et al. Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment. Bone Joint J, May 2015, 97-B(5), 628-635. (Clinical study)
  11. GAO, L., et al. Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair.  Nature Scientif-ic Reports, 2017, 7:45189, DOI: 10.1038/srep45189 (Pre-clinical study)
  12. FRANK, R.M., et al., Failure of Bone Marrow Stimulation Techniques, Sports Med Arthrosc Rev, 2017, 25 (1) (Review of clinical studies)
  13. STEADMAN, J.R., Microfracture Technique for Full-Thickness Chondral Defects: Technique and Clinical Results. Operative Techniques in Orthopaedics. 1997. 7(4), 300-304. (Clinical study)
  14. KAISER, N., et al. Clinical results 10 years after AMIC in the knee. Swiss Med Wkly, 2015, 145 (Suppl 210), 43S. (Clinical study)
  15. VOLZ, M., et al. A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years. Int Orthop, Apr 2017, 41(4), 797-804. (Clinical study)
  16. SCHAGEMANN, J., et al. Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures. Arch Orthop Trauma Surg, Jan 22 2018. (Clinical study)
  17. STEINWACHS, M.R.,et al. Systematic Review and Meta-Analysis of the Clinical Evidence on the Use of Autologous Matrix-Induced Chondrogenesis in the Knee. Cartilage. 2019:1947603519870846. https://www.ncbi.nlm.nih.gov/ pubmed/31508990 (Review of clinical studies)
  18. FOSSUM, V., et al. Collagen-Covered Autologous Chondrocyte Implantation Versus  Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthopaedic Journal of Sports Medicine. 019;7(9):2325967119868212. doi.org/10.1177/2325967119868212 (Clinical study)
Marcelo Roggembaum

National Sales Manager Surgery