Gel ACI (GACI): Articular cartilage repair technique

Abstract

As articular cartilage has only limited ability to regenerate, various treatment options have been developed during the past several decades to treat symptomatic articular cartilage injuries [1, 2]. Among these treatment options available, autologous chondrocyte implantation (ACI), an advanced, cell-based, biologic technology, has become a standard technique used to repair symptomatic, full-thickness, chondral injuries [2]. The traditional ACI technique involves injection of cultured autologous chondrocyte cells into the prepared cartilage defect covered by a periosteal flap. This was the first generation of ACI. However, complications such as periosteal hypertrophy and, less commonly, calcification and delamination have been encountered when periosteum is used as a cover material [3]. Furthermore, improvements in tissue engineering have resulted in a new generation of ACI techniques in which cells are combined with bioactive resorbable biomaterials such as a bilayer type I/III collagen membranes, hyaluronan polymer, and copolymers of polylactin and polyglactin [3]. However, all these techniques require open arthrotomy for the second stage of cell implantation, which has associated patient morbidity and complications [4].