Cartilage regeneration with cultured cartilage cells
During the surgical technique known as Autologous Chondrocyte Implantation (ACI), cartilage cells from your own body, and in fact from the joint that is troubling you, are implanted back in the joint after being multiplied in a specialised laboratory. This is required in some severe cases because in adults, chondrocyte cells are small in number and for repair large numbers of these cells are needed.
ACI is a two-step procedure. In the first step, arthroscopy is performed and a small piece of healthy cartilage (biopsy) is taken, which is then sent to a specialised laboratory for culturing the chondrocytes.
A second surgery is then performed (about 4 to 12 weeks later) to implant the cultured chondrocytes. In this procedure, the chondrocytes are seeded onto a collagen membrane which is then applied to the damaged area. These transplanted cells thrive in their new environment, forming nearly normal articular cartilage.
Although this technique is well suited for large defects, there are some drawbacks:
- Two surgeries are required, one for the biopsy and one for implantation of the cultured cells
- The rehabilitation period is longer as a result of the two surgeries
- The cells may not multiply sufficiently in the laboratory or may not be vital when they are reimplanted so that no regeneration of cartilage takes place
- Cultivation of the cells is very expensive and may not be covered by your health insurance.
Whether you are a candidate for ACI is something your surgeon will decide. This decision will depend on a number of factors such as your age, the extent and severity of chondromalacia, your activity level, the joint which is giving problems and other pertinent medical factors.