AMIC® Patient Information

Postoperative care

You will normally spend a few days in the hospital. You will be required to wear an orthesis for 6 weeks. During this time, full weight bearing is not permitted on the operated leg. Your doctor will give you instructions accordingly. The table below shows you the course of your therapeutic exercise programme. However, your doctor may adjust the programme for your individual needs. Your doctor‘s instructions have precedence and must be strictly followed in order to achieve the desired therapeutic result.

Femoral and tibial defects: AMIC® Patient Information week � week ��� after 6 weeks Autologous Matrix Induced Chondrogenesis Weight foot sole contact foot sole contact build-up to full bearing �-point gait with crutches �-point gait with crutches weight bearing

Mobilization Orthesis Femoral condyle – Free movement (Orthesis in extension) CPM with restrictions: (restricted by pain) week ���: ������° week ���: ������°

Walking, Sport Mobilization aqua gym, swimming Aqua jogging After 8 weeks: cycling After 6 months: jogging, France Your Surgeon skating After ���� months: Geistlich Pharma France SA contact sports Parc des Nations ��� rue de la Belle Etoile BP ����� Patellar and trochlear defects: ����� Roissy CDG Cedex www.geistlich.fr week � week ��� after week 6 Mobilization Orthesis CPM with restrictions: Free movement Germany (Orthesis in extension) week �: ������° (restricted by pain) Geistlich Biomaterials week ���: ������° Vertriebsgesellschaft mbH week ���: ������° Schneidweg � D-����� Baden-Baden Weight Foot sole contact Build-up to full www.geistlich.de bearing �-point gait with crutches weight bearing Italy Geistlich Biomaterials Italia S.r.l Via A. Fogazzaro �� I-����� Thiene VI www.geistlich.it Manufacturer and United Kingdom Distribution in Switzerland Geistlich Sons Ltd. Geistlich Pharma AG Long Lane Business Unit Surgery Chester Bahnhofstrasse 40 CH� � PF CH-���� Wolhusen www.geistlich.co.uk www.geistlich.com �����.������� e Dear Patient Surgical Technique

Your doctor has identified damage to your articular cartilage. To repair the damage, he has re- The surgery can be performed under local or general anaesthesia. Fixation of the Chondro-Gide® matrix commended surgical treatment using the AMIC® method. AMIC® (Autologous Matrix Induced The procedure primarily includes the following steps: The Chondro-Gide® matrix must be attached Chondrogenesis) is a biological method for cartilage repair. This innovative technique uses the in the defect. This is achieved using either fi- body’s own healing potential and the regenerative capacity of mesenchymal stem cells found in brin glue or sutures. The fibrin glue is admini- the bone marrow to grow into chondrocytes or cartilage tissue. The cartilage defect is accessed stered directly to the subchondral bone plate Arthroscopy / mini-arthrotomy through the opening to the joint (arthrotomy). Special instruments are used to remove the around the microperforations. The Chondro- During arthroscopy, the size and classification degenerative cartilage tissue. Gide® matrix is glued into the defect with the of the defect is carefully assessed. Degenera- porous side orientated towards the bone. Several perforations (microfractures) into the subchondral bone plate are made with a sharp tive and detached cartilage is completely re- instrument (awl or pick). The defect is then covered with the Chondro-Gide® matrix. Through moved. The knee joint is then opened. the perforations, bone marrow elements including stem cells and growth factors are released into the defect. Chondro-Gide® stabilizes and protects the migrating cells and thereby provides Flexion of knee and closure an ideal environment for the generation of new cartilage tissue. Once the fibrin glue has set after approx. five Preparation of the template minutes, the excess glue is carefully cut away If cartilage defects are not treated, there is the risk that they can continue to spread and ultimately with a sharp scalpel. The joint is fully flexed lead to arthrosis. A template (sterile aluminium foil) is used to make a correct imprint of the defect. ten times during which the stability and posi- ® ® tion of the Chondro-Gide matrix is checked. Description of the Chondro-Gide Matrix The wound is then sutured closed in layers. Your doctor has decided to use the Chondro-Gide® collagen matrix. In contrast to metal im- plants, this implant supports the formation of new cartilage tissue and is completely resorbed. Chondro-Gide® is a CE-marked implant or medical device for treating cartilage defects. Chondro- ® ® Preparation of the Chondro-Gide Matrix Gide consists of porcine collagen type I and III which is naturally resorbed by the body. Colla- Personal notes: gen is the main structural protein of connec tive tissue and an important component of articular The template is transferred onto the Chondro- ® cartilage. Chondro-Gide® is manufactured in a unique, patented process which results in a bila- Gide matrix and the matrix is cut to the re- yer matrix with a compact and a porous side. quired size.

Safety and Quality The choice of raw materials and the strictly regulated and certified production of Chondro-Gide® meet the highest safety standards and ensure excellent biocompatibility and a consistently high Microfracturing product quality. Chondro-Gide® has been used successfully for many years in the treatment of A sharp awl or pick is used and, if necessary, cartilage defects. Volumes of clinical data and experience docu ment the reliability of Chondro- a mallet to perforate the subchondral bone Gide®. plate every ��� mm to allow bone marrow ma- terial to flow into the defect.

Electron microscope image of the Chondro-Gide® matrix Dear Patient Surgical Technique

Your doctor has identified damage to your articular cartilage. To repair the damage, he has re- The surgery can be performed under local or general anaesthesia. Fixation of the Chondro-Gide® matrix commended surgical treatment using the AMIC® method. AMIC® (Autologous Matrix Induced The procedure primarily includes the following steps: The Chondro-Gide® matrix must be attached Chondrogenesis) is a biological method for cartilage repair. This innovative technique uses the in the defect. This is achieved using either fi- body’s own healing potential and the regenerative capacity of mesenchymal stem cells found in brin glue or sutures. The fibrin glue is admini- the bone marrow to grow into chondrocytes or cartilage tissue. The cartilage defect is accessed stered directly to the subchondral bone plate Arthroscopy / mini-arthrotomy through the opening to the joint (arthrotomy). Special instruments are used to remove the around the microperforations. The Chondro- During arthroscopy, the size and classification degenerative cartilage tissue. Gide® matrix is glued into the defect with the of the defect is carefully assessed. Degenera- porous side orientated towards the bone. Several perforations (microfractures) into the subchondral bone plate are made with a sharp tive and detached cartilage is completely re- instrument (awl or pick). The defect is then covered with the Chondro-Gide® matrix. Through moved. The knee joint is then opened. the perforations, bone marrow elements including stem cells and growth factors are released into the defect. Chondro-Gide® stabilizes and protects the migrating cells and thereby provides Flexion of knee and closure an ideal environment for the generation of new cartilage tissue. Once the fibrin glue has set after approx. five Preparation of the template minutes, the excess glue is carefully cut away If cartilage defects are not treated, there is the risk that they can continue to spread and ultimately with a sharp scalpel. The joint is fully flexed lead to arthrosis. A template (sterile aluminium foil) is used to make a correct imprint of the defect. ten times during which the stability and posi- ® ® tion of the Chondro-Gide matrix is checked. Description of the Chondro-Gide Matrix The wound is then sutured closed in layers. Your doctor has decided to use the Chondro-Gide® collagen matrix. In contrast to metal im- plants, this implant supports the formation of new cartilage tissue and is completely resorbed. Chondro-Gide® is a CE-marked implant or medical device for treating cartilage defects. Chondro- ® ® Preparation of the Chondro-Gide Matrix Gide consists of porcine collagen type I and III which is naturally resorbed by the body. Colla- Personal notes: gen is the main structural protein of connec tive tissue and an important component of articular The template is transferred onto the Chondro- ® cartilage. Chondro-Gide® is manufactured in a unique, patented process which results in a bila- Gide matrix and the matrix is cut to the re- yer matrix with a compact and a porous side. quired size.

Safety and Quality The choice of raw materials and the strictly regulated and certified production of Chondro-Gide® meet the highest safety standards and ensure excellent biocompatibility and a consistently high Microfracturing product quality. Chondro-Gide® has been used successfully for many years in the treatment of A sharp awl or pick is used and, if necessary, cartilage defects. Volumes of clinical data and experience docu ment the reliability of Chondro- a mallet to perforate the subchondral bone Gide®. plate every ��� mm to allow bone marrow ma- terial to flow into the defect.

Electron microscope image of the Chondro-Gide® matrix Dear Patient Surgical Technique

Your doctor has identified damage to your articular cartilage. To repair the damage, he has re- The surgery can be performed under local or general anaesthesia. Fixation of the Chondro-Gide® matrix commended surgical treatment using the AMIC® method. AMIC® (Autologous Matrix Induced The procedure primarily includes the following steps: The Chondro-Gide® matrix must be attached Chondrogenesis) is a biological method for cartilage repair. This innovative technique uses the in the defect. This is achieved using either fi- body’s own healing potential and the regenerative capacity of mesenchymal stem cells found in brin glue or sutures. The fibrin glue is admini- the bone marrow to grow into chondrocytes or cartilage tissue. The cartilage defect is accessed stered directly to the subchondral bone plate Arthroscopy / mini-arthrotomy through the opening to the joint (arthrotomy). Special instruments are used to remove the around the microperforations. The Chondro- During arthroscopy, the size and classification degenerative cartilage tissue. Gide® matrix is glued into the defect with the of the defect is carefully assessed. Degenera- porous side orientated towards the bone. Several perforations (microfractures) into the subchondral bone plate are made with a sharp tive and detached cartilage is completely re- instrument (awl or pick). The defect is then covered with the Chondro-Gide® matrix. Through moved. The knee joint is then opened. the perforations, bone marrow elements including stem cells and growth factors are released into the defect. Chondro-Gide® stabilizes and protects the migrating cells and thereby provides Flexion of knee and closure an ideal environment for the generation of new cartilage tissue. Once the fibrin glue has set after approx. five Preparation of the template minutes, the excess glue is carefully cut away If cartilage defects are not treated, there is the risk that they can continue to spread and ultimately with a sharp scalpel. The joint is fully flexed lead to arthrosis. A template (sterile aluminium foil) is used to make a correct imprint of the defect. ten times during which the stability and posi- ® ® tion of the Chondro-Gide matrix is checked. Description of the Chondro-Gide Matrix The wound is then sutured closed in layers. Your doctor has decided to use the Chondro-Gide® collagen matrix. In contrast to metal im- plants, this implant supports the formation of new cartilage tissue and is completely resorbed. Chondro-Gide® is a CE-marked implant or medical device for treating cartilage defects. Chondro- ® ® Preparation of the Chondro-Gide Matrix Gide consists of porcine collagen type I and III which is naturally resorbed by the body. Colla- Personal notes: gen is the main structural protein of connec tive tissue and an important component of articular The template is transferred onto the Chondro- ® cartilage. Chondro-Gide® is manufactured in a unique, patented process which results in a bila- Gide matrix and the matrix is cut to the re- yer matrix with a compact and a porous side. quired size.

Safety and Quality The choice of raw materials and the strictly regulated and certified production of Chondro-Gide® meet the highest safety standards and ensure excellent biocompatibility and a consistently high Microfracturing product quality. Chondro-Gide® has been used successfully for many years in the treatment of A sharp awl or pick is used and, if necessary, cartilage defects. Volumes of clinical data and experience docu ment the reliability of Chondro- a mallet to perforate the subchondral bone Gide®. plate every ��� mm to allow bone marrow ma- terial to flow into the defect.

Electron microscope image of the Chondro-Gide® matrix PostoperativePostoperative care care

YouYou will will normally normally spend spend a fewa few days days in inthe the hospital. hospital. You You will will be be required required to to wear wear an an orthesis orthesis for for 6 weeks.6 weeks. During During this this time, time, full full weight weight bearing bearing is isnot not permitted permitted on on the the operated operated leg. leg. Your Your doctor doctor willwill give give you you instructions instructions accordingly. accordingly. TheThe table table below below shows shows you you the the course course of of your your therapeutic therapeutic exercise exercise programme. programme. However, However, your your doctordoctor may may adjust adjust the the programme programme for for your your individual individual needs. needs. Your Your doctor‘s doctor‘s instructions instructions have have precedenceprecedence and and must must be be strictly strictly followed followed in inorder order to to achieve achieve the the desired desired therapeutic therapeutic result. result.

FemoralFemoral and and tibial tibial defects: defects: AMICAMIC® Patient® Patient Information Information weekweek � � weekweek ��� ��� afterafter 6 weeks6 weeks AutologousAutologous Matrix Matrix Induced Induced Chondrogenesis Chondrogenesis WeightWeight footfoot sole sole contact contact footfoot sole sole contact contact build-upbuild-up to tofull full bearingbearing �-point�-point gait gait with with crutches crutches �-point�-point gait gait with with crutches crutches weightweight bearing bearing

MobilizationMobilization OrthesisOrthesis FemoralFemoral condyle condyle – – FreeFree movement movement (Orthesis(Orthesis in inextension) extension) CPMCPM with with restrictions restrictions: : (restricted(restricted by by pain) pain) weekweek ���: ���: ������° ������° weekweek ���: ���: ������° ������°

Walking,Walking, Sport SportMobilizationMobilization aquaaqua gym, gym, swimming swimming AquaAqua jogging jogging AfterAfter 8 weeks:8 weeks: cycling cycling AfterAfter 6 months:6 months: jogging, jogging, FranceFrance YourYour Surgeon Surgeon skatingskating AfterAfter ���� ���� months: months: GeistlichGeistlich Pharma Pharma France France SA SA contactcontact sports sports ParcParc des des Nations Nations ������ rue rue de de la laBelle Belle Etoile Etoile BPBP ����� ����� PatellarPatellar and and trochlear trochlear defects: defects: ���������� Roissy Roissy CDG CDG Cedex Cedex www.geistlich.frwww.geistlich.fr weekweek � � weekweek ��� ��� afterafter week week 6 6 MobilizationMobilization OrthesisOrthesis CPMCPM with with restrictions: restrictions: FreeFree movement movement GermanyGermany (Orthesis(Orthesis in inextension) extension) weekweek �: �:������° ������° (restricted(restricted by by pain) pain) GeistlichGeistlich Biomaterials Biomaterials weekweek ���: ���: ������° ������° VertriebsgesellschaftVertriebsgesellschaft mbH mbH weekweek ���: ���: ������° ������° SchneidwegSchneidweg � � D-D-���������� Baden-Baden Baden-Baden WeightWeight FootFoot sole sole contact contact Build-upBuild-up to tofull full www.geistlich.dewww.geistlich.de bearingbearing �-point�-point gait gait with with crutches crutches weightweight bearing bearing ItalyItaly GeistlichGeistlich Biomaterials Biomaterials Italia Italia S.r.l S.r.l ViaVia A. A. Fogazzaro Fogazzaro �� �� I-�����I-����� Thiene Thiene VI VI www.geistlich.itwww.geistlich.it ManufacturerManufacturer and and UnitedUnited Kingdom Kingdom DistributionDistribution in inSwitzerland Switzerland GeistlichGeistlich Sons Sons Ltd. Ltd. GeistlichGeistlich Pharma Pharma AG AG LongLong Lane Lane BusinessBusiness Unit Unit Surgery Surgery ChesterChester BahnhofstrasseBahnhofstrasse 40 40 CHCH� �� PF� PF CH-CH-�������� Wolhusen Wolhusen www.geistlich.co.ukwww.geistlich.co.uk www.geistlich.comwww.geistlich.com �����.������� e �����.������� e Postoperative care

You will normally spend a few days in the hospital. You will be required to wear an orthesis for 6 weeks. During this time, full weight bearing is not permitted on the operated leg. Your doctor will give you instructions accordingly. The table below shows you the course of your therapeutic exercise programme. However, your doctor may adjust the programme for your individual needs. Your doctor‘s instructions have precedence and must be strictly followed in order to achieve the desired therapeutic result.

Femoral and tibial defects: AMIC® Patient Information week � week ��� after 6 weeks Autologous Matrix Induced Chondrogenesis Weight foot sole contact foot sole contact build-up to full bearing �-point gait with crutches �-point gait with crutches weight bearing

Mobilization Orthesis Femoral condyle – Free movement (Orthesis in extension) CPM with restrictions: (restricted by pain) week ���: ������° week ���: ������°

Walking, Sport Mobilization aqua gym, swimming Aqua jogging After 8 weeks: cycling After 6 months: jogging, France Your Surgeon skating After ���� months: Geistlich Pharma France SA contact sports Parc des Nations ��� rue de la Belle Etoile BP ����� Patellar and trochlear defects: ����� Roissy CDG Cedex www.geistlich.fr week � week ��� after week 6 Mobilization Orthesis CPM with restrictions: Free movement Germany (Orthesis in extension) week �: ������° (restricted by pain) Geistlich Biomaterials week ���: ������° Vertriebsgesellschaft mbH week ���: ������° Schneidweg � D-����� Baden-Baden Weight Foot sole contact Build-up to full www.geistlich.de bearing �-point gait with crutches weight bearing Italy Geistlich Biomaterials Italia S.r.l Via A. Fogazzaro �� I-����� Thiene VI www.geistlich.it Manufacturer and United Kingdom Distribution in Switzerland Geistlich Sons Ltd. Geistlich Pharma AG Long Lane Business Unit Surgery Chester Bahnhofstrasse 40 CH� � PF CH-���� Wolhusen www.geistlich.co.uk www.geistlich.com �����.������� e