Treatment of full-thickness chondral defects in the knee with autologous chondrocyte implantation

Autologous chondrocyte implantation (ACI) has now been performed for over a decade in the United States. ACI has been demonstrated as a reproducible treatment option for large, full-thickness, symptomatic chondral injuries of the knee. As clinical experience has expanded and indications broadened to...

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Bibliographic Details
Published in:The journal of orthopaedic and sports physical therapy 2006-10, Vol.36 (10), p.751-764
Main Authors: Gillogly, Scott D, Myers, Thomas H, Reinold, Michael M
Format: Article
Language:English
Subjects:
Cartilage, Articular - transplantation
Chondrocytes - transplantation
Humans
Joint Diseases - surgery
Knee - abnormalities
Knee - physiopathology
Knee Joint - physiopathology
Knee Joint - surgery
Transplantation, Autologous
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Summary:Autologous chondrocyte implantation (ACI) has now been performed for over a decade in the United States. ACI has been demonstrated as a reproducible treatment option for large, full-thickness, symptomatic chondral injuries of the knee. As clinical experience has expanded and indications broadened to more complex cartilage defects, it has become evident that aggressive treatment of coexisting knee pathology is essential for optimal results. This includes management of malalignment, ligamentous, and/or meniscal deficiency, and subchondral bone loss to make the intra-articular environment as ideal as possible for successful cartilage restoration. Additionally, refinements in the rehabilitation necessary for biologic cartilage repair have been made, based on better understanding of the maturation process of the repair cartilage, allowing for earlier initiation of knee range of motion, strengthening exercises, and weight bearing. These changes have enhanced the recovery for the patient and decreased the risk of motion deficits. This article will discuss patient selection for ACI, review ACI surgical technique, including management of coexisting knee pathology, present postoperative ACI rehabilitation guidelines, and summarize clinical outcomes after ACI.
ISSN:0190-6011
1938-1344
DOI:10.2519/jospt.2006.2409