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1.  Outcome of Autologous Matrix Induced Chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry 
Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen I/III scaffold. The purpose of this analysis was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral lesions of the knee.
Methods and materials
Patients treated with AMIC (Chondro-Gide®, Geistlich Pharma, Switzerland) were followed using the AMIC Registry, an internet-based tool to longitudinally track changes in function and symptoms by the Lysholm score and VAS.
A series of 57 patients was enrolled. The average age of patients (19 females, 38 males) was 37.3 years (range 17–61 years). The mean defect size of the chondral lesions was 3.4 cm2 (range 1.0–12.0 cm2). All defects were classified as grade III (n = 20) or IV (n = 37) according to the Outerbridge classification. Defects were localized at the medial (n = 32) or lateral (n = 6) condyle, at the trochlea (n = 4) and at the patella (n = 15). The follow-up period was 2 years. The majority of patients were satisfied with the postoperative outcome, reporting a significant decrease of pain (mean VAS preop = 7.0; 1 year postop = 2.7; 2 years postop = 2.0). Significant improvement of the mean Lysholm score was observed as early as 1 year after AMIC and further increased values were noted up to 2 years postoperatively (preop. 50.1, 1 year postop. 79.9, 2 year postop. 85.2).
AMIC is an effective and safe method of treating symptomatic chondral defects of the knee. However, further studies with long-term follow-up are needed to determine if the grafted area will maintain structural and functional integrity over time.
Level of evidence
Prognostic study, Level IV.
PMCID: PMC3535369  PMID: 23070222
AMIC; Cartilage; Knee; Surgery; Lysholm score
2.  The Effectiveness of Poly-(4-vinyl-N-hexylpyridiniumbromide) as an Antibacterial Implant Coating: An In Vitro Study 
The clinical success of osseointegrated dental implants depends on the strong attachment of the surrounding hard and soft tissues. Bacterial adhesion on implant surfaces can cause inflammatory reactions and may influence healing and long-term success of dental implants. Promising implant coatings should minimize bacterial adhesion, but allow epithelial and connective tissue attachment. Therefore, the present study has examined the bioactive effect of poly-(4-vinyl-N-hexylpyridiniumbromide) regarding typical oral bacteria as well as cytotoxicitiy to human cells considering different methods of connecting polymers to silicate-containing surfaces. The results revealed that the application of putative antibacterial and biocompatible polymer in coating strategies is affected by a variety of parameters. Published findings regarding reduced bacterial adhesion could not be verified using oral pathogens whereas hexylated polymers seem problematic for strong adhesion of soft tissue. Concerning innovative coatings for dental implants basic aspects (surface roughness, thickness, alkylation, combination with other polymers) have to be considered in further investigations.
PMCID: PMC3249688  PMID: 22229031
3.  Autologous Matrix-Induced Chondrogenesis (AMIC) 
Cartilage  2010;1(1):65-68.
Options for the treatment of cartilage defects include chondral resurfacing with abrasion, debridement, autologous chondrocyte transplantation (ACT), matrix-induced chondrocyte transplantation (MACI), or osteochondral autologous transplantation (OATS). This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane by a partially autologous fibrin glue. Indications and contraindications are provided; a technical note is given. This method is primarily applied in osteochondral lesions of the knee and ankle joints; other joints may qualify.
PMCID: PMC4440611  PMID: 26069536
autologous cartilage repair; AMIC; microfracturing
4.  Tumour suppression induced by the macrophage activating lipopeptide MALP-2 in an ultrasound guided pancreatic carcinoma mouse model 
Gut  2004;53(3):355-361.
Background and aim: Carcinoma of the exocrine pancreas has a particularly poor prognosis. Therefore, novel therapeutic strategies such as immunotherapy are required. Here we investigated the immunomodulatory capacity of macrophage activating lipopeptide 2 (MALP-2), which binds to toll-like receptors 2 and 6 and induces activation of nuclear factor κB in monocytes. This causes the release of early stage leucocyte attracting chemokines and proinflammatory cytokines.
Methods: MALP-2 was tested in a new orthotopic ultrasound guided pancreatic cancer mouse model. This model is close to the biological situation and avoids the stress and immunostimulation caused by laparotomy. Cells from the syngeneic, highly aggressive, and metastatic cell line Panc 02 were administered orthotopically, by ultrasound guidance, to C57bl/6 mice. MALP-2 was administered intratumorally or intraperitoneally and tumour growth, immune status, and leucocyte infiltration at the tumour site were determined.
Results: We showed a tumour suppressive effect induced by a single injection of MALP-2. Median survival increased from 21 to 30 days (p<0.002). Combining chemotherapy (gemcitabine) with MALP-2 treatment caused further prolonged survival (median survival 27 days with chemotherapy alone v 37 days for combined treatment; p<0.0002). The life prolonging effect was paralleled by a significant increase in cytotoxic T cells, restoration of β2 integrin expression on lymphocytes, and high expression of CD45RB on T helper cells. Immunohistochemical stains showed strong cytotoxic T lymphocyte and natural killer cell infiltration.
Conclusions: In conclusion, in a model of orthotopic pancreatic cancer in mice, we induced a tumour suppressive effect by treatment with a synthetic lipopeptide. Treatment with MALP-2 could be an option for immunotherapy in pancreatic cancer.
PMCID: PMC1773953  PMID: 14960515
tumour suppression; macrophage activating lipopeptide; MALP-2; pancreatic carcinoma; mouse model; immunotherapy
5.  Bone substitutes as carriers for transforming growth factor-β1 (TGF-β1) 
International Orthopaedics  2002;26(4):203-206.
We studied the suitability of three different hydroxyapatite materials (Endobone, Bio-Oss and Algipore) as carriers for the bone growth promoting factor TGF-β1.The hydroxyapatite materials either were incubated for 24 h or directly loaded with hrTGF-β1 (Diagnostic Products Corporation, DPC) at a concentration of 10 ng hrTGF-β1/mg. For the release experiment the hydroxyapatite materials covered with hrTGF-β1 were either suspended in pure phosphate buffered saline (PBS) or human serum albumin (HSA). The concentration of hrTGF-β1 was measured every 6 h the first day and then daily at the 2nd, 7th, 14th and 28th day. With Bio-Oss and Endobone the release of growth factor in HSA showed a two-phase kinetics. TGF-β1 reached a maximum concentration within the first 24 h and decreased almost linearly until day 28. With Algipore the concentration of growth factor reached a maximum after 12 h and showed a rapid decline until day 2. From day 2 the TGF-β1 concentrations remained low. Significantly, more TGF-β1 was released into HSA than into PBS. Our study suggests that the hydroxyapatite materials are suitable as TGF-β1 carriers.
PMCID: PMC3620956  PMID: 12185519
6.  Arthrolysis of the shoulder for ruptures of the rotator cuff 
International Orthopaedics  1997;21(3):157-160.
Complete repair of tears of the rotator cuff may be difficult, but with superior arthrolysis by the Apoil-Dautry technique the lesion in the cuff is not treated. We report 17 patients who had this procedure for large cuff defects. The outcome is directly related to the duration of symptoms, and we only had good results in a few patients, although intensive physiotherapy improves function. A wide debridement is needed, followed by intensive physiotherapy for the deltoid and shoulder stabilising muscles. We recommended that this technique should be used in elderly patients who will put less demand on their shoulders.
PMCID: PMC3617679  PMID: 9266293

Results 1-6 (6)