Second-generation autologous chondrocyte implantation: What to expect…

Abstract

In this chapter, we highlight the recent advances in the treatment of cartilage lesions in different joints with the so-called second-generation autologous chondrocyte implantation (ACI) products that became available in the market. We point out advantages and disadvantages of the different products based on available literature at the time of writing of this part of the book. The first generation ACI is an accepted treatment for cartilage defects in the knee, with a long-term follow-up showing about 80% of good and excellent results in literature. It has a few well-known drawbacks such as hypertrophy of the repair tissue in 25% of cases and a difficult surgical technique. Second-generation ACI shows great promise for the repair of cartilage lesions as it is much easier to apply surgically and a reoperations rate that is much more favorable. At the time this manuscript was drafted it had not yet been compared to first-generation ACI and microfracture. Longer-term follow-up in well-conducted comparative trials is therefore required.