ACI is seen as the gold standard for cartilage regeneration surgical treatment.
There are 2 steps to the procedure:
Step 1: Surgery is carried out to assess the lesion and harvest cartilage from the periphery of the knee. This allows the patient’s own chondrocytes to be isolated. The cells are sent to the lab, where the cells are expanded and turned into a cartilage transplant graft. This step takes around 8-12 weeks.
Step 2: Once the cartilage graft is ready, it is implanted into the knee in the desired area and fixed into place and sealed. This is a great treatment as it produces true hyaline cartilage from the patient’s own cells, which is the ideal situation.
This operation utilises donor tissue from the knee joint.The patient is assessed with a CT +/- MRI scan and the dimensions of the knee joint and the defect are measured.
An exact match donor is found and the tissue brought to theatre. The donor tissue is cleaned and any host cells removed to eliminate any compatibility issues.
The area of damaged cartilage is prepared and the donor cartilage and bone is cut using specialised equipment and the allograft is placed into the patient’s knee.
This procedure is utilised if other attempts at cartilage regeneration have failed or the lesion is too big to treat with the other methods.
This is essentially a mini arthroplasty procedure where a small part of the diseased joint is replaced with an implant.
Instead of cartilage, the damaged area is replaced with a polyethylene coated implant and fixed into the bone. This provides good coverage of the damaged area and allows the patient to weight bear without pain.
As it is an arthroplasty procedure, it will eventually become loose and will require revision. The short to medium term results are good.