Does the Choice of Acellular Scaffold and Augmentation With Bone Marrow Aspirate Concentrate Affect Short-term Outcomes in Cartilage Repair? A Systematic Review and Meta-analysis.

Background: Matrix-induced chondrogenesis (MIC) is a promising treatment option for critical-size cartilage lesions of the knee; however, there exists substantial heterogeneity in the choice of acellular scaffold matrix for MIC cartilage repairs.

Hypothesis: The choice of acellular matrix will not affect patient outcomes after MIC cartilage repair procedures, and the addition of concentrated bone marrow aspirate (cBMA) will improve short-term patient outcomes regardless of matrix choice.

Study Design: Meta-analysis; Level of evidence, 4.

Survival Analysis of Revision Autologous Chondrocyte Implantation for Failed ACI.

Background: Autologous chondrocyte implantation (ACI) provides a successful outcome for treating articular cartilage lesions. However, there have been very few reports on the clinical outcomes of revision ACI for failed ACI.

Purpose: To evaluate clinical outcomes in patients who underwent revision ACI of the knee for failure of an initial ACI and to determine the factors affecting the survival rate.

Severe Bone Marrow Edema Among Patients Who Underwent Prior Marrow Stimulation Technique Is a Significant Predictor of Graft Failure After Autologous Chondrocyte Implantation.

Background: Autologous chondrocyte implantation (ACI) is a well-established cartilage repair procedure; however, numerous studies have shown higher ACI graft failure rates after prior marrow stimulation techniques (MSTs).

Purpose: To identify which factors may predict decreased graft survival after ACI among patients who underwent a prior MST. A secondary aim was to investigate the specificity of these predictors.

Autologous Chondrocyte Implantation "Segmental-Sandwich" Technique for Deep Osteochondral Defects in the Knee: Clinical Outcomes and Correlation With Magnetic Resonance Imaging Findings.

Background: Symptomatic osteochondral defects are difficult to manage, especially in patients with deep (>8-10 mm) empty defects. The restoration of articular congruence is crucial to avoid the progression to osteoarthritis (OA).

Purpose: To describe the autologous chondrocyte implantation (ACI) "segmental-sandwich" technique for restoration of the osteochondral unit and to evaluate midterm outcomes in patients treated with this procedure.

Open Meniscal Allograft Transplantation With Transosseous Suture Fixation of the Meniscal Body Significantly Decreases Meniscal Extrusion Rate Compared With Arthroscopic Technique.

Purpose: To assess and compare meniscal extrusion rates after lateral "bridge-in-slot" meniscal allograft transplantation (MAT) with arthroscopic versus open insertion.

Methods: In this review of prospectively collected data, we analyzed data from patients who underwent arthroscopic or open lateral MAT. Patients who underwent concomitant distal femoral osteotomy, for whom 1-year postoperative magnetic resonance imaging was unavailable, or who underwent open lateral MAT without the use of transosseous sutures were excluded.

Effects of hydrostatic pressure and deviatoric stress on human articular chondrocytes for designing neo-cartilage construct.

Autologous chondrocyte implantation is a promising therapy for the treatment of the articular cartilage defects. Recently, we have developed a three-dimensional chondrocyte construct manufactured with a collagen gel/sponge scaffold and cyclic hydrostatic pressure. However, the roles of various mechanical stresses, specifically hydrostatic pressure and deviatoric stress, as well as poststress loading, were unclear on metabolic function in chondrocytes.

Autologous Chondrocyte Implantation for Bipolar Chondral Lesions in the Patellofemoral Compartment: Clinical Outcomes at a Mean 9 Years' Follow-up.

Background: Treating bipolar chondral lesions in the patellofemoral (PF) compartment is a challenging problem. There are few reports available on the treatment of bipolar chondral lesions in the PF compartment.

Purpose: To evaluate the clinical outcomes and graft survivorship after autologous chondrocyte implantation (ACI) for the treatment of bipolar chondral lesions in the PF compartment.

Safety, Feasibility, and Radiographic Outcomes of the Anterior Meniscal Takedown Technique to Approach Chondral Defects on the Tibia and Posterior Femoral Condyle: A Matched Control Study.

Objective: Takedown of the anterior meniscus to facilitate exposure of the cartilage defects located on the tibial plateau and/or posterior femoral condyle with subsequent reattachment is being performed clinically; however, clinical evidence is lacking to support the safety of this technique. The aim of this study was therefore to investigate whether meniscal extrusion develops after patients undergo meniscus takedown and transosseous refixation during autologous chondrocyte implantation (ACI).

Design: We analyzed data from 124 patients with a mean follow-up of 6.

A high level of satisfaction after bicompartmental individualized knee arthroplasty with patient-specific implants and instruments.

Purpose: Customized Individually Made (CIM) Bicompartmental Knee Arthroplasty (BKA) implants and three-dimensional printed customized instruments are available to fit to each patient's unique anatomy, medial or lateral with patellofemoral. This study aimed to evaluate the clinical outcomes after CIM-BKA.

Methods: Fifty-five patients [59 knees; average age, 51 years; standard deviation (SD), 6.

Autologous Chondrocyte Implantation for Bipolar Chondral Lesions in the Tibiofemoral Compartment.

Background: Treating bipolar chondral lesions in the tibiofemoral (TF) compartment with cartilage repair procedures is challenging, and a suitable treatment remains unclear.

Purpose: To evaluate clinical outcomes after autologous chondrocyte implantation (ACI) for the treatment of bipolar chondral lesions in the TF compartment.

Study Design: Case series; Level of evidence, 4.

Optimization of Extracellular Matrix Synthesis and Accumulation by Human Articular Chondrocytes in 3-Dimensional Construct with Repetitive Hydrostatic Pressure.

Objective The effects of hydrostatic pressure (HP) on the matrix synthesis by human articular chondrocytes have been reported elsewhere. In order to optimize the production of extracellular matrix, we aimed to clarify the effects of repetitive HP on metabolic function by human articular chondrocytes. Design The human articular chondrocytes were expanded and embedded within a collagen gel/sponge scaffold.

Autologous Chondrocyte Implantation "Sandwich" Technique Compared With Autologous Bone Grafting for Deep Osteochondral Lesions in the Knee.

Background: Treating symptomatic osteochondral defects is challenging, especially in young adults with deep (>8-10 mm) empty defects after osteochondritis dissecans (OCD) or collapsed condyles secondary to avascular necrosis (AVN). For this population, osteoarthritis (OA) is inevitable if articular congruence is not restored.

Purpose: To describe the autologous chondrocyte implantation (ACI) "sandwich" technique with autologous bone grafting (ABG) and compare it with ABG alone for restoration of the osteochondral unit.

A 20-Year Follow-up After First-Generation Autologous Chondrocyte Implantation.

Background: Treating articular cartilage defects is a demanding problem. Although several studies have reported durable and improved clinical outcomes after autologous chondrocyte implantation (ACI) over a long-term period, there is no report with over 20 years' follow-up.

Purpose: To evaluate clinical outcomes after first-generation ACI for the treatment of knees with disabling, large single and multiple cartilage defects for which patients wished to avoid prosthetic arthroplasty, with a minimum of 20 years' follow-up.

Autologous Chondrocyte Implantation to Isolated Patella Cartilage Defects.

Background Autologous chondrocyte implantation (ACI) is a durable treatment for patients with chondral defects. This study presents the comprehensive evaluation of patients with patella defects treated with ACI at medium- to long-term follow-up. Methods Thirty consecutive patients with isolated chondral lesions of the patella were enrolled prospectively.

Intralesional Osteophyte Regrowth Following Autologous Chondrocyte Implantation after Previous Treatment with Marrow Stimulation Technique.

Objective Bone marrow stimulation surgeries are frequent in the treatment of cartilage lesions. Autologous chondrocyte implantation (ACI) may be performed after failed microfracture surgery. Alterations to subchondral bone as intralesional osteophytes are commonly seen after previous microfracture and removed during ACI.

Intermediate- to Long-Term Results of Combined Anterior Cruciate Ligament Reconstruction and Autologous Chondrocyte Implantation.

Background: Cartilage injury associated with anterior cruciate ligament (ACL) ruptures is common; however, relatively few reports exist on concurrent cartilage repair with ACL reconstruction. Autologous chondrocyte implantation (ACI) has been utilized successfully for treatment of moderate to large chondral defects.

Hypothesis: ACL insufficiency with relatively large chondral defects may be effectively managed with concurrent ACL reconstruction and ACI.

Long-term Outcomes of Autologous Chondrocyte Implantation in Adolescent Patients.

Background: Treating symptomatic articular cartilage lesions is challenging, especially in adolescent patients, because of longer life expectancies and higher levels of functional activity. For this population, long-term outcomes after autologous chondrocyte implantation (ACI) remain to be determined.

Purpose: To evaluate long-term outcomes in adolescents after ACI using survival analyses, validated outcome questionnaires, and standard radiographs.

Biological Knee Reconstruction With Concomitant Autologous Chondrocyte Implantation and Meniscal Allograft Transplantation: Mid- to Long-term Outcomes.

Background: Treating articular cartilage defects and meniscal deficiency is challenging. Although some short- to mid-term follow-up studies report good clinical outcomes after concurrent autologous chondrocyte implantation (ACI) and meniscal allograft transplantation (MAT), longer follow-up is needed.

Purpose: To evaluate mid- to long-term outcomes after combined ACI with MAT.

Autologous Chondrocyte Implantation.

Introduction: Autologous chondrocyte implantation (ACI) for the treatment of articular cartilage lesions of the knee joint provides successful and durable long-term outcomes.

Step 1 Preoperative Planning Video 1: Obtain standing radiographs and magnetic resonance imaging (MRI) scans to identify all associated abnormalities (background factors).

Step 2 Arthroscopic Assessment And Cartilage Biopsy Video 2: Evaluate the knee joint systematically and harvest cartilage tissue from the non-weight-bearing area.

Autologous Chondrocyte Implantation: Past, Present, and Future.

Focal cartilage defects of the knee are relatively common and may increase the risk of developing osteoarthritis. Autologous chondrocyte implantation (ACI) aims to restore the integrity of isolated cartilage lesions through the induction of hyaline-like cartilage formation. Although ACI has traditionally been used as a second-line treatment, recent evidence suggests that ACI should be considered as a first-line treatment option in certain patients.

Methods of high integrity RNA extraction from cell/agarose construct.

Background: Agarose hydrogels are widely used for three-dimensional cell scaffolding in tissue engineering and cell biology. Recently, molecular profiles have been obtained with extraction of a minimal volume of RNA using fluorescent-tagged quantitative polymerase chain reaction (qPCR), which requires high integrity RNA. However, the agarose interferes considerably with the quantity and quality of the extracted RNA.

Magnetic resonance imaging of cartilage repair procedures.

Cartilage injuries in the knee are common and can be a persistent source of pain or dysfunction. Many new surgical strategies have been developed to treat these lesions. It is important for the radiologist to have an understanding of these procedures and their appearance on magnetic resonance (MR) imaging.

The quality of healing: articular cartilage.

Articular cartilage lacks an intrinsic capacity for self-repair, and once damaged, it never heals. This creates an opportunity for surgical intervention, whether to stimulate a healing response that results in the formation of a lower-quality fibrocartilaginous scar or formal cartilage repair in the form of cartilage transplants. This article will review the nature of cartilage injury and discuss indications and techniques for repair.

Autologous chondrocyte implantation in the patella: a multicenter experience.

Background: Cartilage defects in the patella are common, and a subset of patients does not respond to nonoperative measures. While most cartilage repair techniques have demonstrated good outcomes in the femoral condyles, the patellofemoral compartment poses special challenges.

Hypothesis: Repair of patellar cartilage defects with autologous chondrocyte implantation (ACI) will provide lasting improvements in pain and function.