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Treatment with Autologous Chondrocyte Implantation (ACI):
Although cartilage in unable to repair itself on its own, advanced FDA-approved
technology allows cartilage cells, know as chondrocytes to be harvested
from your knee and cultured and multiplied. The fresh chondrocytes are then
reimplanted in your knee and cause hyaline cartilage to regenerate. This
biological repair is known as ACI. When you successfully complete ACI and
rehabilitation, you should be able to resume all normal activities, including
sports.
ACI, also known as Carticel treatment, restores the articular surface
and regenerates hyaline cartilage without compromising the integrity of
healthy tissue or the subchondral bone.
Carticel has demonstrated important benefits in patients with a type
of lesion called a femoral focal lesion. If your orthopedic surgeon has
determined that you have this type of lesion, then Carticel may be an
appropriate treatment option.
The procedure consists of two steps. The first is the harvesting of
some healthy cartilage from your knee through an arthroscope. This sample
of cartilage is used to create new chondrocytes, which take 3-4 weeks
that are then reimplanted in your knee.
The second step is the reimplantation of the cultured chondrocytes,
or Carticel. This procedure is done through an arthrotomy, and is depicted
below.
Implantation of Carticel:
Step 1
An arthroscopic biopsy - First, the surgeon
examines your knee through an arthroscope - a small device that allows
the doctor to see into your knee joint. If a lesion is detected, a tiny
biopsy of healthy cartilage tissue will be removed.
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Step 2
Cell culture processing - The cartilage sample is then sent to Genyzme
Tissue Repair (GTR), where it is cultured. Cell culturing takes about
4-5 weeks, during which time your cells multiply significantly. About
12 million cells will be supplied to your surgeon at the time of your
operation.
Step 3
A surgical procedure is performed, and the damaged cartilage is
removed.
Step 4
Periosteum, skin that covers the bone, is sutured over the prepared
defect.
Step 5
Surgical implantation - The cultured cells are then implanted into
the lesion. Here, the cells may continue to multiply and intergrate
with surrounding cartilage. With time, the cells will mature and
fill-in the lesion with hyaline cartilage.
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Post-Operative Rehabilitation:
To derive maximum benefit
from ACI, you should adhere strictly to the personalized rehabilitation
plan recommended by your physician. This will include progressive weight-bearing,
range of motion, and muscle strengthening exercises which may begin as early
as the day after surgery.
Is ACI right for
you?
Consult your SCOI doctor
to determine Carticel is right for you.
For more information,
please see http://www.carticel.com
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is Copyright ©2004 Southern California Orthopedic Institute.
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