title: Evolution of autologous chondrocyte repair and comparison to other cartilage repair techniques.
abstract: Articular cartilage defects have been addressed using microfracture, abrasion chondroplasty, or osteochondral grafting, but these strategies do not generate tissue that adequately recapitulates native cartilage. During the past 25 years, promising new strategies using assorted scaffolds and cell sources to induce chondrocyte expansion have emerged. We reviewed the evolution of autologous chondrocyte implantation and compared it to other cartilage repair techniques.
  
  
  METHODS
  We searched PubMed from 1949 to 2014 for the keywords "autologous chondrocyte implantation" (ACI) and "cartilage repair" in clinical trials, meta-analyses, and review articles. We analyzed these articles, their bibliographies, our experience, and cartilage regeneration textbooks.
  
  
  RESULTS
  Microfracture, abrasion chondroplasty, osteochondral grafting, ACI, and autologous matrix-induced chondrogenesis are distinguishable by cell source (including chondrocytes and stem cells) and associated scaffolds (natural or synthetic, hydrogels or membranes). ACI seems to be as good as, if not better than, microfracture for repairing large chondral defects in a young patient's knee as evaluated by multiple clinical indices and the quality of regenerated tissue.
  
  
  CONCLUSIONS
  Although there is not enough evidence to determine the best repair technique, ACI is the most established cell-based treatment for full-thickness chondral defects in young patients.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Ashvin K
authors.initials: AK
authors.lastname: Dewan
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Gibson
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Elisseeff
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Trice
mesh_terms: D002358:Cartilage, Articular / Q000254:growth & development* / Q000473:pathology; D019902:Chondrocytes / Q000473:pathology / Q000637:transplantation*; D020219:Chondrogenesis; D006801:Humans; D012038:Regeneration; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D014945:Wound Healing