Autologous Chondrocyte Implantation
Articular cartilage is a white, glistening tissue that surfaces the ends of the bone in a joint. Full-thickness cartilage defects may occur on the end of the thigh bone (femur) or kneecap (patella), most often following trauma or injury to the knee. This specialized surface, which is smooth, firm, and resilient, has relatively little ability to repair or regenerate itself. When the articular defect exceeds a “thumbnail” size (approximately 2 cm2), autologous (grafting tissue from your own body) chondrocyte (cells that generate cartilage matrix) implantation may be an alternative. This option is usually best suited to younger patients with normal knee alignment and a relatively normal meniscus (cartilage ring). The defects must be focal rather than diffuse in nature. Small segments of healthy articular cartilage are harvested from the margins of your own knee through tiny incisions arthroscopically. That cartilage tissue is sent to a special lab where millions of the your own cartilage cells are carefully grown in a sterile culture. After approximately one month, those cells may be reimplanted into the your own knee. During that second surgery, performed in an open manner, a small sheet of tissue is sewn around the margin of the defect, which is sealed with a biologic “glue” and serves as a roof over the defect to protect the new cells. The cultured cells are then delivered into the defect with a small needle and syringe. The cells adhere to the exposed bone and begin to generate new articular cartilage. Protected weight bearing is necessary for a period of 8 – 10 weeks as the new cartilage surface begins to develop. Physical therapy is employed to assist you in regaining range-of-motion and leg strength. Full recovery for unrestricted activities is typically 9 – 12 months.