Articular cartliage has a limited regeneration capacity, due to the absence of blood vessels and the low mitogenic potency of the chondrocytes. Self-healing of the defect is not possible.
When untreated, depending on its location and size, this defect will progress and ultimately result in osteoarthritis. To prevent this destructive process, articular cartilage surgery aims to restore the structure and function of hyaline cartilage.
Geistlich treatment approach
Geistlich focuses on regenerative minimally invasive methods and the development of products that support self-healing processes in the body. The aim is to repair articular cartilage, provide pain relief to the patient and slow down the progression of damage. Depending on a person's age and activity level, the approach preserves or extends the patient's usual lifestyle before alternative treatments like joint replacement have to be considered.
With Chondro-Gide® Geistlich has developed a collagen scaffold designed for regenerative therapies. This membrane can be used in combination with different established approaches to cartilage repair. The application of Chondro-Gide® with marrow stimulation techniques led to a successful co-development of a matrix and technique, today known as AMIC® (Autologous Matrix Induced Chondrogenesis). AMIC® combines bone marrow stimulation (BMS) with the application of the bilayer membrane. Following BMS , cells migrate into the defect. The membrane, Chondro-Gide® which is used to cover the defect provides the cells with a colonisation scaffold, thus stabilising and protecting the resulting super clot. In this 'biological chamber' the cells differentiate and form repair tissue. The smooth and cell occlusive surface side of the matrix, prevents cells from diffusing into the joint space and protects them from stresses in the joint.
Whether cells are sourced on-site via BMS, harvested from another site in the body and applied to the membrane or even cultured on the membrane - the goal is a mobilisation of the body's repair mechanism and the generation of cartilage tissue within the defect.
The same philosophy was applied in Arthroscopic Matrix based Meniscus Repair (AMMR®). The damaged tissue is enveloped in the Chondro-Gide® membrane, which forms a ‘biological chamber’ around the meniscus. Bone Marrow Blood Aspirate is then injected into that protected, contained space to support the healing process.