Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. Healthy cartilage in our joints
makes it easier to move. It allows the bones to glide over each other with very little friction. Articular cartilage can be damaged by injury or normal wear
and tear. Because cartilage does not heal itself well, doctors have developed surgical techniques to stimulate the growth of new cartilage. Restoring articular
cartilage can relieve pain and allow better function. Most importantly, it can delay or prevent the onset of arthritis. At the Advanced Orthopedic Institute
at Ingalls, experts now offer several revolutionary new procedures to repair or restore damaged cartilage without the need for joint replacement surgery,
including Autologous Chondrocyte Implantation, or ACI.
ACI is a two-step procedure. New cartilage cells are grown and then implanted in the cartilage defect. First, healthy cartilage tissue is removed from
a non-weightbearing area of the bone. This step is done as an arthroscopic procedure. The tissue that contains healthy cartilage cells, or chondrocytes, is
then sent to the laboratory. The cells are cultured and increase in number over a 3- to 5-week period. An open surgical procedure, or arthrotomy, is then done
to implant the newly grown cells. The cartilage defect is prepared. A layer of bone-lining tissue, called periosteum, is sewn over the area. This cover is
sealed with fibrin glue. The newly grown cells are then injected into the defect under the periosteal cover. ACI is most useful for younger patients who have
single defects larger than 2 cm in diameter. ACI has the advantage of using the patient's own cells, so there is no danger of a patient rejecting the tissue.