title: Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: A guideline by the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU).
abstract: BACKGROUND
  Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee.
  
  
  METHODS
  The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI.
  
  
  RESULTS
  Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication.
  
  
  CONCLUSIONS
  The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI.
  
  
  METHODS
  Non-systematic Review.
authors.affiliation: Department Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Germany. Electronic address: philipp.niemeyer@uniklinik-freiburg.de.
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authors.initials: P
authors.lastname: Niemeyer
authors.affiliation: Klinik im Kronprinzenbau, Reutlingen, Germany.
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authors.lastname: Albrecht
authors.affiliation: Orthopädie und Unfallchirurgie, Ortho AC, Aachen, Germany.
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authors.lastname: Andereya
authors.affiliation: Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany; Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany.
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authors.lastname: Angele
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Tübingen, Germany.
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authors.lastname: Ateschrang
authors.affiliation: Kliniken Leipziger Land GmbH, Klinikum Borna, Germany.
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authors.affiliation: Kreiskliniken Esslingen, Klinik f. Unfallchirurgie - Orthopädische Chirurgie, Esslingen, Germany.
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authors.lastname: Baumann
authors.affiliation: Zentrum f. Orthopädische Chirurgie, Sporttraumatologie, INI Hannover, Germany.
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authors.lastname: Bosch
authors.affiliation: Center of Biologie Joint Repair, Zürich, Switzerland.
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authors.affiliation: Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Fickert
authors.affiliation: Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany.
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authors.lastname: Gebhard
authors.affiliation: Abteilung für Unfallchirurgie, Universitätsklinikum Erlangen, Germany.
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authors.affiliation: Klinik für Unfallchirurgie, Medizinische Hochschule Hannover (MHH), Germany.
authors.forename: D
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authors.lastname: Günther
authors.affiliation: Universitätsmedizin Berlin-Charite, Klinik für Orthopädie, Unfall u. Wiederherstellungschirurgie, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hoburg
authors.affiliation: Orthopädisch Chirurgisches Centrum, Tübingen, Germany.
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authors.affiliation: Unfallchirurgie/Orthopädie, DRK Krankenhaus Luckenwalde, Germany.
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authors.affiliation: Zentrum für Experimentelle Orthopädie, Universitätsklinikum des Saarlandes, Homburg, Germany.
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authors.lastname: Madry
authors.affiliation: Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien und Austrian Cluster for Tissue Regeneration, Austria.
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authors.initials: S
authors.lastname: Marlovits
authors.affiliation: Sektion Pädiatrische Sportmedizin, Kinderorthopädie, Altonaer Kinderkrankenhaus Hamburg, Germany.
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authors.initials: NM
authors.lastname: Meenen
authors.affiliation: Orthopädische Klinik, Ludwig-Maximiliams-Universität München, Germany.
authors.forename: P E
authors.initials: PE
authors.lastname: Müller
authors.affiliation: Evangelisches Waldkrankenhaus Spandau, Klinik f. Orthopädie und Unfallchirurgie, Berlin, Germany.
authors.forename: U
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authors.lastname: Nöth
authors.affiliation: Zentrum f. operative Medizin, Klinik für Unfall-, Hand- u. Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany.
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authors.initials: JP
authors.lastname: Petersen
authors.affiliation: Orthopädische Klinik, Ludwig-Maximiliams-Universität München, Germany.
authors.forename: M
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authors.lastname: Pietschmann
authors.affiliation: Forschungszentrum für Experimentelle Orthopädie, Universitätsklinikum Heidelberg, Germany.
authors.forename: W
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authors.lastname: Richter
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Tübingen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Rolauffs
authors.affiliation: Viktoria Klinik Bochum, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Rhunau
authors.affiliation: Orthopädisch Chirurgisches Centrum, Tübingen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Schewe
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Universität Würzburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Steinert
authors.affiliation: Hirslanden Sportklinik Birshof, Basel, Switzerland.
authors.forename: M R
authors.initials: MR
authors.lastname: Steinwachs
authors.affiliation: UKE Athletikum Hamburg, Germany.
authors.forename: G H
authors.initials: GH
authors.lastname: Welsch
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, St. Vinzenz-Hospital Dinslaken, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Zinser
authors.affiliation: Orthopädisch Chirurgisches Centrum, Tübingen, Germany.
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mesh_terms: D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods*
keywords: Cartilage defect; Cartilage repair; Knee joint; Osteoarthritis; Recommendations