AMIC Cartilage Repair in a Professional Soccer Player

We report a case of a professional soccer player suffering from a traumatic cartilage lesion grade IV according to the Outerbridge classification at the femoral condyle treated with an enhanced microfracture technique (AMIC). Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen scaffold and fibrin glue. Because of the cartilage lesion (3？cm2), an AMIC procedure was performed followed by a rehabilitation program according to the protocols in the literature, (Steadman et al.; 2003). After 8 months of rehabilitation, the player returned to team training and after 10 months to competition. Altogether he returned to the same skill level for almost one year after the index operation. He is very satisfied with the clinical results after AMIC, which corresponds with the Lysholm score of 90 points at 12 months. 1. Introduction Articular cartilage defects are one of the most common causes of permanent disability in athletes. Excessive stress on a joint with an articular cartilage defect may accelerate further degenerative changes and predispose the athlete to a higher risk of osteoarthritis. Athletes require an articulating cartilage surface that can withstand the high mechanical joint stresses generated during their specific sports activity. Treatment of an athlete with articular cartilage damage is consequently a significant challenge to healthcare professionals. We report a case of a professional soccer player suffering from a traumatic cartilage lesion treated with an enhanced microfracture technique (AMIC). 2. Case Report A 28-year-old professional soccer player suffered an anterior cruciate ligament tear after a tackling in a soccer game. He underwent a routine anterior cruciate ligament reconstruction with use of quadruple hamstring autograft and bioabsorbable fixation of the implants. He recovered well and returned to competition after 6 months. Another 2 month later he injured his knee hitting the ground with the lateral side of the knee. He referred immediately discomfort but no apparent effusion and he continued to play on. After one week, the discomfort progressed despite physiotherapy. An orthopaedic assessment was made for persistent pain located at the lateral aspect of the knee. At that time the treating surgeon performed a diagnostic arthroscopy and it was confirmed that the patient had a cartilage lesion grade IV according to the Outerbridge classification at the femoral condyle (Figure 1). He was referred to the authors