Classical ACI for chondral and osteochondral defects

Abstract

Autologous chondrocyte implantation is difficult for the surgeon. It will challenge your ability to accurately diagnose the source of pain, require careful patient selection, involve a range of techniques to correct associated abnormalities (meniscal replacement, realignment osteotomies, ACL reconstruction) and require skills in handling 6/0 sutures in confined spaces. In addition, these patients have high expectations of a cell therapy. Many of the decisions you will make cannot be tested by hypothesis-based research and will not appear in clinical journals. You must visit and interrogate those with experience and observe their practice in the clinic and in theatre. Join the International Cartilage Repair Society (a healthy mix of surgeons and scientists) and attend their ICRS workshops. This book chapter will give you some insights into the practice of a single surgeon who has endeavoured to optimise a practice of early arthritis surgery in a unit with its own GMP lab and treatment and follow-up of 450 patients over 15 years who have chondral defects of the knee, hip and ankle.