title: Autologous Chondrocyte Implantation With Collagen Membrane.
abstract: The first-generation autologous chondrocyte implantation (ACI-P) described by Peterson and colleagues used a periosteal patch to form a watertight cover over the articular cartilage defect, under which the autologous chondrocyte suspension was injected. Although good to excellent outcomes were often seen in >80% of patients and the durability of the repair documented up to 20 years, the procedure was noted to have a high rate of subsequent surgical procedures, most often for arthroscopic debridement of periosteal hypertrophy or incomplete incorporation. Consequently, the surgical technique advanced to use a porcine-derived bilayer of type I/III collagen with a porous layer that favors cell attachment and a smooth, compact layer that is cell occlusive. In use of the collagen membrane ACI, prospective studies have shown no diminution in clinical results and a marked reduction in subsequent surgeries from graft hypertrophy to <3%. Use of the collage membrane for ACI-C in the United States is currently an off-label use of an FDA-approved membrane, which should be discussed with the patient before surgery.
authors.affiliation: Atlanta Sports Medicine & Orthopaedic Center, Atlanta, GA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Gillogly
authors.forename: Kris S
authors.initials: KS
authors.lastname: Wheeler
mesh_terms: D000818:Animals; D019643:Arthroplasty, Replacement / Q000379:methods*; D001182:Arthroscopy; D019902:Chondrocytes / Q000637:transplantation*; D003094:Collagen / Q000627:therapeutic use*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003094:Collagen