As treatment options for repair of articular cartilage defects have continued to evolve
over the past decade with promising new techniques of tissue transfer using osteochondral
autografts and allografts as well as cellular repair with autologous chondrocyte implantation,
there has been intense focus on optimizing the use of these methods. While no treatment
option is ideal for all full-thickness cartilage defects, nonetheless, the goal remains
a repair that can restore the normal surface congruity of the joint, control the patients’
symptoms, maintain the durability to withstand the intra-articular forces of the knee
over time, and prevent the progression of focal chondral injuries to osteoarthritis.
These newer treatment methods continue to be evaluated as to their indications, consistency
and reproducibility of outcomes, durability of repair, and cost-effectiveness.
1
The technique of autologous chondrocyte implantation (ACI), first reported by Brittberg
et al.
2
in 1994, has gained considerable interest and acceptance, particularly for treatment
of large full-thickness chondral injuries. In this technique, a small biopsy specimen
of healthy chondral tissue is obtained arthroscopically when the lesion is identified
and then undergoes in vitro chondrocyte cell culture returning a 12-fold increase
in autologous chondrocyte cells available for implantation into the defect at the
second stage of the procedure. The principle behind using autologous chondrocytes
is to produce a repair tissue that more closely resembles the morphologic characteristics
of hyaline cartilage, and is thus better able to restore the durability and natural
function of the knee joint.To read this article in full you will need to make a payment
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© 2003 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
