What is Autologous Chondrocyte Implantation?

Autologous Chondrocyte Implantation (ACI) is a procedure suitable for larger cartilage defects in the knee (larger than 2 by 3 cm). It is a procedure that has been performed for nearly 20 years and involves taking a biopsy of patient cartilage, growing and culturing your own cartilage cells in a lab, and then re-implanting new cartilage to the defect around 6 weeks later.

NICE (National Institute of Clinical Excellence) approved ACI as a procedure that can be performed on the NHS in October 2017.

Am I suitable?

ACI is suitable in those patients with large cartilage defects (more than 2 by 3 cm) and with no arthritis in the knee. Those patients with smaller defects would be suitable for micro-fracture or other regenerative procedures (e.g. concentrated cells with a scaffold).

What does the procedure involve?

After being deemed suitable for the procedure (this is done following an MRI scan and consultation), an arthroscopy is performed as a day-case procedure and a small piece of cartilage is removed from a non-weight bearing part of the knee. This is sent to a cartilage laboratory and cells are cultured (grown) over a 4-6 week period. Once a large number of cells have been grown, these are returned to the hospital on the planned day of surgery.

The second operation is via an open approach and the cells are implanted onto the cartilage defect. Cells can be implanted onto a scaffold to cover the defect, or a membrane is stitched around the defect and the cells are injected into the membrane.

The second procedure involves an overnight stay in hospital and you are placed in a brace for 6 weeks (partially weight bearing).

What is the recovery?

Full recovery is 3 – 6 months and intensive physiotherapy is required to restore the normal movement and muscle function.

What are the outcomes?

ACI has an overall 5 year success rate of around 60-70%. It has the best outcomes for all regenerative procedures in the knee.

I want to thank Mr. Datta for taking such good care of me during both hip replacement procedures. It was my first major surgery and he helped calm my nerves. Both surgeries were successful and the after care was excellent. I am now completely pain free and able to do things I was not able to do for a number of years.

S Kirby

I must say my overall experience at Spire under Mr Datta was first class and I am very grateful to all involved

Peter L

My care and treatment has been excellent. From my first consultation through to my surgery, I have been kept well informed and have had all the information I’ve needed to ensure the surgery went well and that I make a speedy recovery. I would highly recommend Mr Datta.

Mr King

I had a total knee replacement done and had the best care. Yes did experience a long wait to go to surgery but that's expected in most hospitals. Was in for 3 days and couldn't fault the care, nurses and cleanliness of the hospital. Lovely food. One nurse in particular always managed to make me smile

P Elliott

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