Cartilage injury repair and regeneration

Articular cartilage is the smooth surface that covers the bones to create the mobile joints. It is a very specialised tissue which has no real capacity to heal itself if injured. Articular cartilage defects can be caused by trauma or can occur spontaneously. Often over time a defect will progress to osteoarthritis where large parts or the majority of the surface become damaged. (pot holes vs a worn out road surface) If you have an isolated defect of the bearing surface it may be suitable for and require treatment to help the defect to heal.

If the piece of cartilage is still attached to a piece of underlying bone there is a chance it can be fixed back into place, this is normally only possible in children and young adults. The type of cartilage repair needed will depend on the size of the defect and how much bone is involved. If the defect is small (less than 2 square cm) then a cell free procedure like AMIC can be used to heal an isolated cartilage defect. This involves shaping the defect to create a well contained crater and then inserting a biological scaffold to help the healing of the cartilage defect similar to the techniques used for ACI but without the cultured.

Defects that do not heal following AMIC or large defects where AMIC is not likely to work may be suitable for more advanced surgical procedures. These include osteochondral grafting where a plug of healthy cartilage is moved from another part of the knee (OATS/mosaicplasty) to fill the defect or autologus chondrocyte implantation which is a form of cell regeneration therapy (ACI or MACI).

ACI preparation