P Niemeyer1, D Albrecht2, S Andereya3, P Angele4, A Ateschrang5, M Aurich6, M Baumann7, U Bosch8, C Erggelet9, S Fickert10, H Gebhard11, K Gelse12, D Günther13, A Hoburg14, P Kasten15, T Kolombe16, H Madry17, S Marlovits18, N M Meenen19, P E Müller20, U Nöth21, J P Petersen22, M Pietschmann20, W Richter23, B Rolauffs5, K Rhunau24, B Schewe15, A Steinert25, M R Steinwachs26, G H Welsch27, W Zinser28, J Fritz15. 1. Department Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Germany. Electronic address: philipp.niemeyer@uniklinik-freiburg.de. 2. Klinik im Kronprinzenbau, Reutlingen, Germany. 3. Orthopädie und Unfallchirurgie, Ortho AC, Aachen, Germany. 4. Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany; Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany. 5. Berufsgenossenschaftliche Unfallklinik Tübingen, Germany. 6. Kliniken Leipziger Land GmbH, Klinikum Borna, Germany. 7. Kreiskliniken Esslingen, Klinik f. Unfallchirurgie - Orthopädische Chirurgie, Esslingen, Germany. 8. Zentrum f. Orthopädische Chirurgie, Sporttraumatologie, INI Hannover, Germany. 9. Center of Biologie Joint Repair, Zürich, Switzerland. 10. Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany. 11. Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany. 12. Abteilung für Unfallchirurgie, Universitätsklinikum Erlangen, Germany. 13. Klinik für Unfallchirurgie, Medizinische Hochschule Hannover (MHH), Germany. 14. Universitätsmedizin Berlin-Charite, Klinik für Orthopädie, Unfall u. Wiederherstellungschirurgie, Germany. 15. Orthopädisch Chirurgisches Centrum, Tübingen, Germany. 16. Unfallchirurgie/Orthopädie, DRK Krankenhaus Luckenwalde, Germany. 17. Zentrum für Experimentelle Orthopädie, Universitätsklinikum des Saarlandes, Homburg, Germany. 18. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien und Austrian Cluster for Tissue Regeneration, Austria. 19. Sektion Pädiatrische Sportmedizin, Kinderorthopädie, Altonaer Kinderkrankenhaus Hamburg, Germany. 20. Orthopädische Klinik, Ludwig-Maximiliams-Universität München, Germany. 21. Evangelisches Waldkrankenhaus Spandau, Klinik f. Orthopädie und Unfallchirurgie, Berlin, Germany. 22. Zentrum f. operative Medizin, Klinik für Unfall-, Hand- u. Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany. 23. Forschungszentrum für Experimentelle Orthopädie, Universitätsklinikum Heidelberg, Germany. 24. Viktoria Klinik Bochum, Germany. 25. Orthopädische Klinik, König-Ludwig-Haus, Universität Würzburg, Germany. 26. Hirslanden Sportklinik Birshof, Basel, Switzerland. 27. UKE Athletikum Hamburg, Germany. 28. Klinik für Orthopädie und Unfallchirurgie, St. Vinzenz-Hospital Dinslaken, Germany.
Abstract
BACKGROUND: Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee. METHODS: The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI. RESULTS: Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication. CONCLUSION: The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI. LEVEL OF EVIDENCE: Non-systematic Review.
BACKGROUND: Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee. METHODS: The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI. RESULTS: Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication. CONCLUSION: The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI. LEVEL OF EVIDENCE: Non-systematic Review.
Authors: Robert Ossendorff; Kilian Franke; Benjamin Erdle; Markus Uhl; Norbert P Südkamp; Gian M Salzmann Journal: Int Orthop Date: 2018-06-16 Impact factor: 3.075