Gilat Ron, Weissman Alexander C, Phillips Andrew R, Yazdi Allen A, Muth Sarah A, Cole Brian J
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Video J Sports Med. 2025 Jun 26;5(3):26350254241303767. doi: 10.1177/26350254241303767. eCollection 2025 May-Jun.
Damage to the joint surface, which affects articular cartilage and the underlying subchondral bone, is a common cause for significant knee pain and disfunction. The use of CartiHeal Agili-C, a cell-free aragonite-based implant, is an emerging option for patients who may otherwise be a poor candidate for allograft transplantation or within geographic areas where there is a limited availability of donor tissue.
The CartiHeal Agili-C implant is indicated for patients with an International Cartilage Repair Society grade III or IV lesion with a total treatable area of 1 to 7 cm and without severe osteoarthritis.
Standard parapatellar arthrotomy is performed to reveal an osteochondral defect of the femoral condyle. The cell-free aragonite-based scaffold is then transplanted in 7 steps according to numbered instrumentation in the Agili-C toolset. Surgical pearls of placement include proper alignment of the perpendicular aligner tool with circumferential viewing, assistant confirmation, and arthroscopic verification; avoiding wobbling during the shaping phase of the procedure as this may cause an oblong socket with inadequate fixation; and handling the implant with care and only using a thumb or index finger to insert with light tapping.
A multicenter randomized control trial followed 251 patients and found 88.5% of the implant group had at least 75% lesion fill as seen on postoperative magnetic resonance imaging at a 2-year follow-up. Additionally, patient-reported outcome measures were statistically superior when compared to controls at 24 months.
Transplantation of a cell-free aragonite-based scaffold (Aglili-C; CartiHeal Ltd), augmented with bone marrow aspirate concentrate, provides an efficient, reproducible surgical strategy in the management of osteochondral defects of the femoral condyles.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
关节面损伤会影响关节软骨及下方的软骨下骨，是导致膝关节剧痛和功能障碍的常见原因。对于那些可能不适合进行同种异体移植或在供体组织供应有限的地区的患者，使用基于文石的无细胞植入物CartiHeal Agili-C是一种新的选择。
CartiHeal Agili-C植入物适用于国际软骨修复协会III级或IV级损伤、可治疗总面积为1至7平方厘米且无严重骨关节炎的患者。
采用标准髌旁关节切开术暴露股骨髁的骨软骨缺损。然后根据Agili-C工具组中的编号器械，分7步移植基于文石的无细胞支架。植入的手术要点包括：垂直对准工具与圆周观察、助手确认和关节镜检查的正确对齐；在手术塑形阶段避免晃动，因为这可能会导致固定不充分的椭圆形窝；小心处理植入物，仅用拇指或食指轻轻敲击插入。
一项多中心随机对照试验对251名患者进行了随访，发现植入组88.5%的患者在术后2年的磁共振成像中显示至少75%的损伤得到填充。此外，在24个月时，患者报告的结局指标在统计学上优于对照组。
移植添加了骨髓抽吸浓缩物的基于文石的无细胞支架（Aglili-C；CartiHeal Ltd），为治疗股骨髁骨软骨缺损提供了一种有效、可重复的手术策略。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可识别，作者已随本提交的出版物附上患者的豁免声明或其他书面批准形式。
