ACI-C Versus AMIC. A Randomized Trial Comparing Two Methods for Repair of Cartilage Defects in the Knee

NCT ID: NCT01458782

Last Updated: 2025-02-17

Study Results

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2025-12-30

Brief Summary

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ACI-C versus AMIC: A controlled randomized trial comparing Autologous Chondrocyte Implantation ( ACI) and Autologous Matrix Induced Chondrogenesis (AMIC) for repair of cartilage defects in the knee.

Eighty patients (Forty in each group) having symptomatic cartilage defects in their knee are planned to include in this study.

Both techniques will use the ChondroGide membrane from Geistlich to cover the defects. ACI includes an arthroscopy to harvest cartilage for cell cultivation in our lab located in Tromso. 3-4 weeks later using a mini arthrotomy the cells will be implanted under the ChondroGide membrane.

The AMIC group will be listed for a mini arthrotomy, cleaning of the defect, microfracture and cover of the defect using the same ChondroGide membrane.

In both groups stitches and fibrin glue will be used to fix the membrane.

Inclusion criteria:

Age between 18-60, Informed consent signed by patient, Symptomatic cartilage defect. Size more than 2 square cm.

Exclusion criteria Alcohol or drug abuse during the last three years, Inflammatory joint disease, Serious illness

Preoperative examination and follow up: Clinical examination and registration of KOOS (a validated knee score), VAS (visual analog pain scale) and Lysholm knee score. Radiographs of the involved knee including weightbearing standing radiographs of both knees. Kellgren- Lawrence classification will be used for grading of OA.

Patients will be checked after 1, 2, 5 and 10 years following surgery. Symptomatic patients having a new cartilage resurfacing operation or prosthesis will be listed as failures of the initial treatment.

Hypothesis: AMIC will be equal to ACI, and if that is the case this would be a benefit for the patients and the society. AMIC is much cheaper compared to ACI (needing an expensive cell cultivation and two surgeries).

Data will be analyzed using the SPSS statistical package.

Detailed Description

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Please see referenced articles (1-3) for details regarding ACI and AMIC

Conditions

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Osteochondritis Dissecans Osteoarthritis Cartilage Injury Osteonecrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

RCT, Two arms ACI-C and AMIC
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ACI-C

Autologous chondrocyte implantation using collagen membrane (ChondroGide) Please see reference 1 and 2 for details regarding ACI. In this study we are using the collagen membrane instead of periosteum- the other details are exactly the same as in our previous RCT.

Group Type ACTIVE_COMPARATOR

Treatment of cartilage defects in the knee

Intervention Type PROCEDURE

Two groups, either ACI or AMIC. ACI includes an arthroscopy for harvesting of cartilage 3-4 weeks prior to the open cartilage surgery. AMIC includes only open surgery at one setting.

AMIC

Autologous matrix induced chondrogenesis. Microfracture of the defect and covering using the collagen membrane (ChondroGide).

Please see reference 3 for details regarding AMIC

Group Type ACTIVE_COMPARATOR

Treatment of cartilage defects in the knee

Intervention Type PROCEDURE

Two groups, either ACI or AMIC. ACI includes an arthroscopy for harvesting of cartilage 3-4 weeks prior to the open cartilage surgery. AMIC includes only open surgery at one setting.

Interventions

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Treatment of cartilage defects in the knee

Two groups, either ACI or AMIC. ACI includes an arthroscopy for harvesting of cartilage 3-4 weeks prior to the open cartilage surgery. AMIC includes only open surgery at one setting.

Intervention Type PROCEDURE

Other Intervention Names

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Autologous chondrocyte implantation Autologous matrix induced chondrogenesis

Eligibility Criteria

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Inclusion Criteria

* age between 18-60 yrs
* informed consent signed by patient
* symptomatic cartilage defect in the knee \> 2 square cm

Exclusion Criteria

* alcohol or drug abuse during the last three yrs
* inflammatory joint disease
* serious illness
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Tromso

OTHER

Sponsor Role collaborator

University Hospital of North Norway

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gunnar Knutsen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital of North Norway

Ann Kristin Hansen, MD, PhD

Role: STUDY_DIRECTOR

University Hospital of North Norway

Locations

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University Hospital of North Norway

Tromsø, Troms, Norway

Site Status

Countries

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Norway

References

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Knutsen G, Drogset JO, Engebretsen L, Grontvedt T, Isaksen V, Ludvigsen TC, Roberts S, Solheim E, Strand T, Johansen O. A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at five years. J Bone Joint Surg Am. 2007 Oct;89(10):2105-12. doi: 10.2106/JBJS.G.00003.

Reference Type BACKGROUND
PMID: 17908884 (View on PubMed)

Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grontvedt T, Solheim E, Strand T, Roberts S, Isaksen V, Johansen O. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg Am. 2004 Mar;86(3):455-64. doi: 10.2106/00004623-200403000-00001.

Reference Type BACKGROUND
PMID: 14996869 (View on PubMed)

Benthien JP, Behrens P. The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments. Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1316-9. doi: 10.1007/s00167-010-1356-1. Epub 2011 Jan 14.

Reference Type BACKGROUND
PMID: 21234543 (View on PubMed)

Fossum V, Hansen AK, Wilsgaard T, Knutsen G. Collagen-Covered Autologous Chondrocyte Implantation Versus Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee. Orthop J Sports Med. 2019 Sep 17;7(9):2325967119868212. doi: 10.1177/2325967119868212. eCollection 2019 Sep.

Reference Type DERIVED
PMID: 31555714 (View on PubMed)

Other Identifiers

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2011/1159-3

Identifier Type: -

Identifier Source: org_study_id

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