RESUMO
PURPOSE: Bone marrow mesenchymal stem cells were introduced into clinical practice due to their ability to differentiate into many types of cells. Autologous matrix-induced chondrogenesis (AMIC) combines the microfracture method with matrix-based techniques that utilizes a collagen membrane to serve as a scaffold for new bone marrow mesenchymal stem cells, allowing effective reconstruction of even large fragments of a damaged cartilage surface. METHODS: All-arthroscopic technique to repair knee cartilage defects using the AMIC technique, which includes the use of a collagen matrix (porcine collagen type I and III) and fibrin glue-technique presentation. CONCLUSION: This technical note introduces an all-arthroscopic AMIC technique to reconstruct extensive cartilage defects (without bone defects). The technique may be used for treatment of all location of knee cartilage lesions. LEVEL OF EVIDENCE: V.
Assuntos
Artroscopia/métodos , Cartilagem Articular/cirurgia , Cartilagem/transplante , Condrogênese/efeitos dos fármacos , Articulação do Joelho/cirurgia , Cartilagem/efeitos dos fármacos , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Colágeno , Adesivo Tecidual de Fibrina , Humanos , Articulação do Joelho/efeitos dos fármacos , Articulação do Joelho/patologia , Procedimentos de Cirurgia Plástica/métodos , Transplante Autólogo , CicatrizaçãoRESUMO
PURPOSE: The number of meniscus surgeries, including partial or complete meniscectomy, has increased considerably with the progress in knee arthroscopy. An analysis of treatment results, carried out at several centres by numerous study groups, showed a development of early degenerative changes in the knees of treated patients. METHODS: This study is aimed at developing a fully arthroscopic technique to treat meniscal tears by suturing and wrapping them in collagen matrix, followed by injection of liquid bone-marrow collected from the tibial proximal epiphysis, into the area of meniscal lesion. RESULTS: In this paper, we presented arthroscopic technique for wrapping meniscal tears using the collagen matrix sutured with the Fast-Fix sutures. CONCLUSIONS: Proposed surgical technique is not straightforward to perform, but can be learned by adhering to strict arthroscopic principles. The use of collagen matrix and bone marrow aspirate from bone-marrow blood, including stem cells, creates favourable biological conditions for meniscus healing, which may increase the rate of healing.