title: Combination of autologous chondrocyte implantation (ACI) and osteochondral autograft transfer system (OATS) for surgical repair of larger cartilage defects of the knee joint. A review illustrated by a case report.
abstract: OBJECTIVE
  Modern orthopaedic surgery provides a variety of techniques for cartilage repair. Despite comprehensive scientific data about the single procedures, there is little experience with the combination of these methods. Inspired by a case from our clinic, we performed a PubMed based literature search about the combination of cartilage restoration principles.
  
  
  METHODS
  The literature search was performed using the terms: ``mosaicplasty'' OR ``osteochondral transplantation'' OR ``OATS'' AND ``autologous chondrocyte implantation'' OR ``autologous chondrocyte transplantation'' OR ``ACI'' OR ``matrix-associated autologous chondrocyte implantation'' OR ``MACI'' AND ``combination''. Abstracts were revised for relevance to our case. Additionally, we present a case report of the combinatory use of three established techniques.
  
  
  RESULTS
  Two relevant publications, both reporting satisfying results concerning postoperative functional outcome, were found. Our results confirm this first encouraging assessment, although statistically valid data and prospective studies are still missing.
  
  
  CONCLUSIONS
  The simultaneous use of different techniques for cartilage repair may provide alternative operative solutions for single complex cases, although further studies are required for a general recommendation.
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Duif
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Mohamed Abou
authors.initials: MA
authors.lastname: Koutah
authors.affiliation: Medical Practice Duisburg, Ruhr-University Bochum, Germany.
authors.forename: Ole
authors.initials: O
authors.lastname: Ackermann
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Spyrou
authors.affiliation: Faculty of Health, University of Witten/Herdecke, Witten, Germany.
authors.forename: Lars Victor
authors.initials: LV
authors.lastname: von Engelhardt
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Daimi
authors.initials: D
authors.lastname: Kaya
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Roland E
authors.initials: RE
authors.lastname: Willburger
authors.affiliation: Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Lahner
mesh_terms: D002358:Cartilage, Articular / Q000601:surgery*; D019902:Chondrocytes; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D014182:Transplantation, Autologous / Q000379:methods*
keywords: ACI; Cartilage repair; OATS; mosaicplasty; osteochondral defect