Chondrocyte (cartilage) implantation has been around for about 20 years. It has become the number one choice to repair large lesions in the articular cartilage of the knee. When using your own cells, the procedure is referred to as an autologous chondrocyte implantation (ACI).
The procedure is in two parts. First the surgeon harvests donor cells from another area in the knee. Cells are preferred from an area of minimal weight-bearing status. Then the surgeon will clean up the damaged area. Any frayed tissue will be shaved smooth.
A small patch from the outer most layer of bone is harvested. The patch is stitched over the lesion. Then the donor cells are injected under the patch. The patch is then sealed with sutures and a special glue.
There are plusses and minuses about this procedure. The advantages are that the lesion fills in with desirable cartilage. The repair is durable and will hold up under normal use. This treatment is very good for large areas of cartilage damage.
On the downside, it is a staged-procedure (two operations). The rehab time is considerable and requires the patient’s time and dedication. Some studies report a high rate of failure and reoperation. There are other less complicated procedures but for a large full-thickness cartilage injury, recent studies hold this one up as the best choice.