Skip to main content
SpringerLink
Log in

The Illustrative First and Second Generation Autologous Chondrocyte Implantation (ACI) for Cartilage Repair

  • Chapter
  • First Online:
The Illustrative Book of Cartilage Repair

Abstract

Autologous chondrocyte implantation (ACI) was first introduced clinically in 1987 [1]. In this procedure, cartilage biopsies are harvested from a minor load-bearing area of the knee. These cartilage slices are then sent to a cartilage laboratory for cell isolation and expansion for several weeks. The expanded increased numbers of cells are returned to the surgeon as a chondrocyte suspension. The cell suspension is to be injected into the defect covered with a membrane of periosteum (first generation, P-ACI). The periosteum being a living tissue could develop into a hypertrophy with mechanical symptoms as a consequence, requiring a revision surgery to shave off the hypertrophied periosteum. Hence some years later, use of the collagen membrane (second generation, C-ACI) started instead of a periosteum patch to reduce the chances of hypertrophy, graft delamination, etc. The second-generation ACI with a collagen membrane had less chances of a revision surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331(14):889–95.

    Google Scholar 

  2. Peterson L, Vasiliadis HS, Brittberg M, Lindahl A. Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med. 2010;38(6):1117–24.

    Google Scholar 

  3. Nawaz SZ, Bentley G, Briggs TW, Carrington RW, Skinner JA, Gallagher KR, Dhinsa BS. Autologous chondrocyte implantation in the knee: mid-term to long-term results. J Bone Joint Surg Am. 2014;96(10):824–30.

    Google Scholar 

  4. Rosa D, Balato G, Ciaramella G, Soscia E, Improta G, Triassi M. Long-term clinical results and MRI changes after autologous chondrocyte implantation in the knee of young and active middle aged patients. J Orthop Traumatol. 2016;17(1):55–62.

    Google Scholar 

  5. Ogura T, Mosier BA, Bryant T, Minas T. A 20-year follow-up after first-generation autologous chondrocyte implantation. Am J Sports Med. 2017;45(12):2751–76.

    Google Scholar 

  6. Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85-A(2):185–92.

    Google Scholar 

  7. Schneider U, Andereya S. [First results of a prospective randomized clinical trial on traditional chondrocyte transplantation vs CaReS-technology]. Z Orthop Ihre Grenzgeb. 2003;141(5):496–97.

    Google Scholar 

  8. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.

    Google Scholar 

  9. Visna P, Pasa L, Cizmár I, Hoch J. Treatment of deep cartilage defects of the knee using autologous chondrograft transplantation and by abrasive techniques—a randomized controlled study. Acta Chir Belg. 2004;104(6):709–14.

    Google Scholar 

  10. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grøntvedt T, Solheim E, et al. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg Am. 2004;86-A(3):455–64.

    Google Scholar 

  11. Bartlett W, Skinner JA, Gooding CR, Carrington RW, Carrington RW, Flanagan AM, Briggs TW, et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg Br. 2005;87(5):640–5.

    Google Scholar 

  12. Dozin B, Malpeli M, Cancedda R, Bruzzi P, Calcagno S, Molfetta L, et al. Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med. 2005;15(4):220–6.

    Google Scholar 

  13. Gooding CR, Bartlett W, Bentley G. A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: periosteum covered versus type I/III collagen covered. Knee. 2006;13(3):203–10.

    Article  CAS  Google Scholar 

  14. Zeifang F, Oberle D, Nierhoff C, Richter W, Moradi B, Schmitt H. Autologous chondrocyte implantation using the original periosteum-cover technique versus matrix-associated autologous chondrocyte implantation: a randomized clinical trial. Am J Sports Med. 2010;38(5):924–33.

    Google Scholar 

  15. Basad E, Ishaque B, Bachmann G, Stürz H, Steinmeyer J. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):519–27.

    Google Scholar 

  16. Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, et al. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med. 2011;39(12):2566–74.

    Google Scholar 

  17. Cole BJ, Farr J, Winalski CS, Richmond J, Mandelbaum B, De Deyne PG. Outcomes after a single-stage procedure for cell-based cartilage repair: a prospective clinical safety trial with 2-year follow-up. Am J Sports Med. 2011;39(6):1170–9.

    Google Scholar 

  18. Crawford DC, DeBerardino TM, Williams RJ 3rd. NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years. J Bone Joint Surg Am. 2012;94(11):979–89.

    Article  Google Scholar 

  19. Saris D, Price A, Widuchowski W, Bertrand-Marchand M, Caron J, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42(6):1384–94.

    Google Scholar 

  20. Clavé A, Potel JF, Servien E, Neyret P, Dubrana F, Stindel E. Third-generation autologous chondrocyte implantation versus mosaicplasty for knee cartilage injury: 2-year randomized trial. J Orthop Res. 2016;34(4):658–65.

    Google Scholar 

  21. Brittberg M, Recker D, Ilgenfritz J, Saris DBF; SUMMIT Extension Study Group. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: five-year follow-up of a prospective randomized trial. Am J Sports Med. 2018;46(6):1343–51.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cartilage Research Unit, University of Gothenburg, Region Halland Orthopaedics, Kungsbacka Hospital, Kungsbacka, Sweden

    Mats Brittberg

Authors
  1. Mats Brittberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mats Brittberg .

Editor information

Editors and Affiliations

  1. Saumya Arthroscopy and Sports Knee Clinic, Ahmedabad, India

    Deepak Rajkumar Goyal

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brittberg, M. (2021). The Illustrative First and Second Generation Autologous Chondrocyte Implantation (ACI) for Cartilage Repair. In: Goyal, D.R. (eds) The Illustrative Book of Cartilage Repair. Springer, Cham. https://doi.org/10.1007/978-3-030-47154-5_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-47154-5_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47153-8

  • Online ISBN: 978-3-030-47154-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation