Autologous Chondrocyte Implantation


Chondrocytes (articular cartilage cells) build articular cartilage by forming a matrix – a complex combination of proteins and water. When articular cartilage is damaged, it does not repair itself effectively like other tissues. Autologous Chondrocyte Implantation (ACI) involves implanting chondrocytes into an area of cartilage damage. The theory is that the cells subsequently form new articular cartilage.

ACI is suitable for treating cartilage damage caused by direct injury such as sports injuries, car accidents or falls, where the damaged area is surrounded by normal healthy cartilage. There are two procedures required.

The first operation involves the surgeon taking a small biopsy or sample of your articular cartilage. The operation is performed as a day case and an overnight stay is usually not necessary. The articular cartilage biopsy is then sent to a tissue-engineering laboratory.

The biopsy is processed, releasing the articular cartilage cells from the articular cartilage. They are placed in a nutrient rich medium where they divide until an optimal number of cells is attained. This usually takes between three and four weeks. At the end of the process, the cells are usually placed or ‘seeded’ onto a matrix of collagen.

The second operation is performed to deliver and glue the new cells and collagen matrix into the damaged area. To ensure the implanted cells are protected, it is necessary to stay in hospital for a number of days to allow progressive joint mobilisation. A special rehabilitation program is required, which involving bracing of the knee and a gradual return to full weight bearing.

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