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I'm looking into every aspect of a procedure I might have on my knee. It's called autologous chondrocyte implantation. What can you tell me about this operation? Does it hold up over time? In other words, how long will it last for me?

We have some information that might help you. Back in 1995 when surgeons first started using a technique called autologous chondrocyte implantation (ACI), a group of surgeons from around the United States set up a special study to track results of this treatment. They called the collection of data from patients at various clinics and surgical centers the Cartilage Repair Registry or Registry for short. The goal was to follow patients long enough to see how well this treatment worked over time. The results of this research help answer the question of just how durable is this repair procedure? Autologous chondrocyte implantation (ACI) refers to the filling in of cracks and holes in the knee joint cartilage with the patient's own chondrocytes (cartilage cells). These lesions or defects occur as a result of trauma, injury, or repetitive damage to the joint. Autologous means that normal, healthy cartilage cells are taken from a place in the patient's own knee joint. The cells come from an area that isn't damaged and doesn't bear a huge load when the person is upright and weight-bearing. The harvested chondrocytes have the advantage of being accepted (not rejected) by the patient's body. Five years ago, results from the registry were reported. An area of key interest was the durability of the implantation. At that time, results were good-to-excellent for the majority (80 per cent) of patients. There was even evidence that as time went by in the early years, patients continued to improve. Now the researchers present results after 10 years. They used the outcomes after five years and compared it with the results after 10 years to assess durability. Success was defined as a confirmed defect filling, patient satisfaction with results, and no need for further treatment for the problem. Failure was determined as the need to remove the graft for any reason, the need for partial or complete joint replacement, and failure of the defect to fill in (seen on imaging studies). Most of the failures (17 per cent) occurred early on (in the first two and a half years) Those who improved in the first five years stayed that way -- they didn't get better or worse. The authors take this to mean that early improvement after autologous chondrocyte implantation is maintained years later. The authors concluded that autologous chondrocyte implantation (ACI) is a successful procedure for full-thickness (clear to the bone) holes in the articular cartilage of the knee. Pain, swelling, and knee function can be resolved in most patients who are carefully selected for this procedure. The results occur early and last up to 10 years, which is considered long-term.


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