Autologous Chondrocyte Implantation (ACI)

Who is the Candidate for ACI?

People who are possible candidates for ACI have a region of damaged cartilage on their knee(s). The pain and swelling, or swelling that restricts their movement impels them to seek this surgery.

How is the ACI Conducted?

ACI is a two-step procedure, which are as follows:

• Knee Arthroscopy The specialist uses arthroscopy in which little bits of ligament, including ligament cells (chondrocytes), are collected from a non-weight-bearing zone of the joint. The ligament sample is sent to a laboratory, where the cells are separated and refined for 3– 5 weeks to acquire adequate number of cells (somewhere in the range of 5 and 10 million cells).
• Knee Implantation The second step in the process includes a cut being made in the knee, so that the surgeon can see the ligament. Another cut over the shinbone (tibia) is made to make way for a thick connective tissue known as periosteum. A periosteal layer is then reaped and sewn over the harmed ligament. When the procedure is finished, the new cells are embedded under the layer where they will be fixed.

What are the Possible Risks and Complications of ACI?

The most widely recognised difficulty is thickening (hypertrophy) of the 'patch' which was used to cover the cartilage defect. The thickening is because of increased friction between the knee and the implanted cartilage, and poorly conducted surgery.

For patients who want to continue their career in sports, a recovery period of 9 to 12 months is a long time and can put them in dilemma about choosing this procedure.

Postoperative Care and Recovery Period

After the procedure, patients are advised to undergo rehabilitation a program. Usually, recovery starts with motion training, partial weight-bearing, and the continuous passive motion (CPM), in which a gadget keeps the joint in motion without help. This goes on for around 10– 12 weeks. In the first 3 months, patients switch to the prescribed diet to gain weight. The operational joint is continuously exercised until it can bear weight without damaging itself.