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Use of Autologous Chondrocyte Implantation in the Knee

Athletes are known to be at high risk of developing osteoarthritis of the knee due to increased weightbearing activities and high impact "loading." These injuries first present as articular cartilage defects of the knee, mostly lesions found on the femur, or thigh bone.

Doctors commonly classify the cartilage injury with the Outerbridge and International Cartilage Research Society (ICRS), however the authors of this study propose a new score called the Chondropenia Severity Score (CSS), which takes into account the curve inside the knee.

In diagnosing articular cartilage lesions, doctors use a combination of patient history, clinical examination and results from x-rays and scans. Treatment involves surgical repair through lavage (cleaning), debriding (removing dead tissue), drilling, or microfracture, introducing small holes in the bones to allow marrow to seep out and harden.

Of the various methods of treatment to repair the cartilage, there does not appear to be one superior form as the treatment depends on the extent of the injury and the patient him or herself. The aim is to return the patient to his or her previous level of activity with a minimum of discomfort, without increasing the risk of osteoarthritis later on in life. A newer technique, articular cartilage regeneration is proving promising.

In this procedure, cultured chondrocytes (cells) are used to regenerate tissue, thereby healing the injured cartilage. The authors of this article write, "long-term studies ... will determine the efficacy of articular cartilage repair to reverse chondropenia and prevent development of secondary arthritic degeneration."

References: Timothy R. McAdams and Bert r. Mandelbaum. Knee Reconstruction - Articular cartilage regeneration in the knee. In Current Orthopedic Practice. March/April 2008. Vol. 19. No. 2. Pp. 140-145.

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