Autologous Chondrocyte Implantation for Traumatic Large Cartilage Defect
Cholawish Chanlalit MD*, Channarong Kasemkijwattana MD*, Vithaya Varavit MD**
Affiliation : * Department of Orthopedics, Faculty of Medicine, Srinakharinvirot University, Nakhon Nayok ** Department of Radiology, Faculty of Medicine, Srinakharinvirot University, Nakhon Nayok
Objective : The authors report the immediate result (6 months) after Autologous Chondrocyte Implantation
(ACI) in clinical and anatomic result with MRI. This is the first report of ACI that provides chondrocyte cells
from a domestic lab.
Materials and Methods : ACI was done in a two-stage procedure, first stage via arthroscope to harvest cartilage
and detect pathology. The authors found deep cartilage defect at grade 4 according ICRS, area 2.5 cm2 and
near total meniscus tear. Meniscal repair and cartilage shaving were done. Harvesting 300 mg of cartilage
was done in this stage. Four weeks later, the second ACI was done. Lateral para-patellar was used. Periosteum
was used as chondrocyte suspension and by suture to the healthy cartilage, using prolene interrupted suture
in conjunction with fibrin glue to seal the pocket after injecting the cell. Range of motion exercise started on
day 2, assisted with continuous passive motion machine. Running and jumping were restricted for 9 months.
Results : No complication was found, full range of motion and walking was done at 7-8 weeks post operative.
Visual analogue scale improved from 3 points to 0 point. MRI shows evidence of 100% filling of the repair
tissue in defect site associated with hypertrophy of the repair tissue above chondral surface.
Conclusion : Immediate result of ACI shows improvement in clinical and anatomic that present with MRI.
Further follow up and case series is needed.
Keywords : Knee injury, Autologous chondrocyte implantation, Cartilage defect
