S. Tabet (Albuquerque, US)New Mexico Orthopedic Assn. Orthopaedics
Presenter Of 1 Presentation
10.2.3 - Prospective Evaluation of a Fresh Amniotic Membrane for the Treatment of Cartilage Defects
Cartilage has a limited healing potential due to its lack of vascularization and the innate nature of chondrocytes. Amniotic membranes contain extracellular matrix, proteoglycans, growth factors, and progenitor cell populations1 expected to be beneficial for supporting cartilage repair and protecting the repair site. Previous ovine studies using amniotic membrane for chondral repair have demonstrated improved cartilage quality2,3. In the current clinical study, we evaluated the effectiveness of a fresh, hypothermically-stored amniotic membrane (HSAM) in supporting chondral repair.
Methods and Materials
In 10 patients with ICRS grade III lesions or above, sharp dissection of the defect to normal healthy cartilage was performed. HSAM was laid in the defect bed and secured in place with fibrin glue. Effectiveness of repair was evaluated using MRI, VAS, and KOOS measurements at baseline, 6, 12, 18, and 24 months. Optional biopsies of the chondral repair at 24 months were taken with patient consent and stained using standard histological and immunohistochemical stains for cartilage specific targets.
Currently, the study is fully enrolled, and 2 subjects have reached the end of study (24 months). MOCART scoring demonstrated defect fill in 100% of patients and all repaired defects showed good integration with adjacent cartilage. KOOS scoring showed improvements in all subscales for up to 18 months (Figure 1A). VAS average joint pain scores had an average change from baseline of -27.50±26.52 at 6 months, -27.61±24.42 at 12 months, and -32.32±28.45 at 18 months. At the time of this abstract, one patient biopsy has been stained and showed Collagen II staining within the repair (Figure 1B).
In this 10-patient pilot study, HSAM resulted in improved pain and function scores, defect fill, and high-quality cartilage repair. This evidence supports the use of HSAM in the treatment of chondral defects.