Autologous Cartilage Implantation (ACI)
Articular Cartilage Repair Surgery
Indication and Procedure Description
This procedure is indicated for those patients who have an isolated full thickness articular cartilage defect in the knee, which is causing symptoms such as pain and clicking. This injury is generally from an acute injury, but can also occur over time, due to repeated injuries. The knee is generally swollen and pain is located over the site of the cartilage injury. It is not a suitable procedure for established osteoarthritis as yet.
The procedure involves taking a biopsy (sample) of the healthy cartilage from the knee through an arthroscopy (keyhole surgery). The size of the defect will also be assessed at this time. The cartilage biopsy is processed in a laboratory where the cartilage cells will be cultivated in a matrix and this takes approximately four to six weeks. Once the matrix or cartilage is ready, it will then be re-implanted. The re-implantation occurs through an arthrotomy where the joint is opened through a small incision to allow accurate placement of the cartilage graft.
After a thorough clinical assessment of the joint, the patient will generally have plain X-rays and an MRI scan of the knee to help accurately assess the location and size of the cartilage defect. At times, the patient may have previously had an arthroscopy. A range of motion brace will be
organized prior to the surgery and this will restrict the joint movement and protect the cartilage graft.