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Autologous Chondrocyte Implantation

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    Autologous Chondrocyte Implantation

    Autologous chondrocyte implantation (ACI) is a surgical procedure that involves the 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.

    Indications

    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.

    Candidates

    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.

    Procedure

    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 the 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.

    Recovery

    The post-operative autologous chondrocyte implantation recovery 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 MACI knee 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.

    Frequently Asked Questions

    Ideal candidates for ACI are usually young to middle-aged adults with isolated cartilage defects in their knee joints. They should have tried conservative treatments without sufficient relief. ACI is not typically recommended for patients with advanced osteoarthritis, widespread cartilage damage, or inflammatory joint diseases.

    Recovery from ACI can be extensive and typically involves several phases. Initial recovery might take about 6 to 12 weeks, during which the patient will need to limit weight-bearing activities. Full recovery, including the return to high-impact sports or activities, can take up to 12 to 18 months, depending on the individual’s healing process and adherence to rehabilitation protocols.

    Like any surgical procedure, ACI carries risks, including infection, blood clots, or complications related to anesthesia. Specific to ACI, there can be issues such as graft delamination (the graft peeling away from the bone), uneven cartilage growth, stiffness, or persistent pain. Patients should discuss these risks with their surgeon before undergoing the procedure.

    Rehabilitation is a critical component of recovery after ACI. It typically includes physical therapy to restore range of motion, strength, and function. The rehab protocol often begins with gentle movements and progresses to more intensive exercises over time. Patients must follow their rehabilitation plan closely to ensure optimal outcomes.

    ACI has shown good to excellent outcomes in many patients, especially in terms of pain relief and improved joint function. Studies have indicated that ACI can be effective in repairing cartilage defects and providing long-term benefits. However, individual results may vary, and the success of the procedure can depend on factors such as the size and location of the defect, patient age, and adherence to postoperative care and rehabilitation.