Full-thickness defects to the cartilage along the bottom of the femur (thighbone) can cause significant pain and loss of function. Treatment often includes debridement, microfracture, and osteochondral autograft.
When these methods don’t work, there is another approach called autologous chondrocyte implantation (ACI). With ACI, the damaged area is cleared of dead cells. The joint surface is smoothed and made ready. A small piece of a bone covering called the periosteum is patched over the hole.
Healthy cartilage is taken from the patient and sent to a lab where five to 10 million new cells are grown from the sample. The new cells are injected under the periosteal patch. They grow and mature and fill in the defect.
ACI can be expensive. The cost of cells can be as much as $25,000. But this method of restoring the joint surface has other cost savings. Patients get back to a high level of function.
Less time in pain and with improved function gained by ACI also affects quality of life. The cost of being out of work or unable to care for the family must be factored in.
Many health care plans see the benefit of ACI and are including this treatment in their plans. ACI may help the most challenging patients who have not benefitted from other treatments for cartilage defects.