Technique of all arthroscopic autologous chondrocyte implantation (ACI) for the treatment of cartilage defects in the knee

Operative Orthopädie und Traumatologie
Michael SchlumbergerJörg Richter

Abstract

All arthroscopic treatment of deep cartilage defects in the knee for reconstruction of the articular surface. Focal cartilage defects of the knee (ICRS ≥ grade 3) from a size of 2.5 cm2 and more. Osteoarthritis (Kellgren-Lawrence > grade 2), osseus defect situation, cartilage lesion of the opposing articular surfaces (ICRS > grade 2), instability, malalignment (>3-4°), inflammatory joint diseases. First procedure (cell harvesting): Treatment of additional pathologies, preparation of the cartilage defect, harvesting of osteochondral cylinders for cell culture. Second procedure (cell implantation): Dry arthroscopy, cleaning and drying of the already prepared defect, implantation of the in situ crosslinking cartilage cell suspension. First procedure (cell harvesting): Early functional treatment with weight bearing as tolerated. Second procedure (cell implantation): No drains, extension brace for 4 days, then free range of motion, partial weight bearing for 4 weeks in patellofemoral implantation and for 8 weeks in tibiofemoral implantation, continuous passive motion beginning in postoperative week 2, cycling from postoperative week 9. In the literature, results for ACI in the knee are reported to be good, especially for larger cart...Continue Reading

References

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