Autologous chondrocyte implantation (ACI) is a surgical procedure that involves implantation of healthy cartilage cells (chondrocytes) into an area of damaged cartilage in the joint. The chondrocytes are harvested from the patient's own body, grown in a laboratory, and then implanted into the damaged area of the joint. This procedure is typically performed on the knee joint, but may also be performed on other joints, such as the ankle or shoulder.
The indications for ACI are typically for patients who have a large cartilage defect without underlying bony involvement, that cannot be treated with other conservative treatments such as physical therapy, medications, or injections. Patients who have a history of trauma or sports injuries may benefit from ACI.
The ideal candidates for ACI are typically younger patients with a single large cartilage defect and minimal osteoarthritis. They should be in good overall health and have realistic expectations for the surgical outcome.
The ACI procedure typically involves two surgeries. The first surgery involves a biopsy of healthy cartilage from the patient's joint. The chondrocytes are then isolated and grown in a laboratory for several weeks. The second surgery involves implantation of the cultured chondrocytes into the damaged area of the joint. The chondrocytes are implanted into the joint under a patch, which is sewn in or glued onto the damaged area of the joint.
The post-operative recovery for ACI can be lengthy, with patients required to wear a brace or use crutches for several weeks after the surgery. Physical therapy and rehabilitation are typically required for several months after the surgery to help the patient regain strength and mobility in the joint. Return to sports activities can take anywhere from 6-12 months.
The success of ACI depends on several factors, including the size and location of the cartilage defect, the age and overall health of the patient, and the level of activity or stress placed on the joint after surgery. However, ACI has been shown to be an effective treatment for patients with large cartilage defects without bony involvement who have not responded to other conservative treatments.