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For example, in the Study of the Treatment of Articular Repair (STAR), 49% of Carticel ACI patients underwent an SSP on the treated knee, during the 4-year follow up. The most common serious adverse events (up to 5% of patients), include arthrofibrosis and joint adhesions, graft overgrowth, chondromalacia or chondrosis , cartilage injury, graft ...
Rehabilitation following any articular cartilage repair procedure is paramount for the success of any articular cartilage resurfacing technique. The rehabilitation is often long and demanding. The main reason is that it takes a long time for the cartilage cells to adapt and mature into repair tissue. Cartilage is a slow adapting substance.
They reported a case study in which a full-thickness defect in the articular cartilage of a human knee was successfully repaired. [23] While the use of cultured mesenchymal stem cells has shown promising results, a more recent study using uncultured MSC's has resulted in full-thickness, histologically confirmed hyaline cartilage regrowth.
The AMIC procedure was first proposed by Behrens in 2003. it aims to extend the use of microfracture surgery to larger cartilage lesions > 2.5 cm2. [5] Its clinical efficiency in autologous chondrocyte implantation (ACI), another cartilage repair technique for larger cartilage lesions, has been studied. [6] [7] [8]
There are several different repair options available for cartilage damage or failure. "Maci" or autologous cultured chondrocytes on porcine collagen membrane, is a treatment to correct cartilage defects in the knee. This treatment has been approved by the Food and Drug Administration in 2016 for adult treatment only. [1]
Articular cartilage stem cell paste grafting was initially described by Kevin R. Stone M.D., a San Francisco-based orthopedic surgeon, in 1997 . The technique was devised in response to reports that many of the contemporary cartilage restoration procedures lead to the development of fibrocartilage , not true hyaline articular cartilage .
The International Cartilage Repair Society has set up an arthroscopic grading system by which cartilage defects can be ranked: grade 0: (normal) healthy cartilage; grade 1: the cartilage has a soft spot, blisters, or superficial wear; grade 2: minor tears of less than one-half the thickness of the cartilage layer
The procedure is less effective in treating older patients, overweight patients, or a cartilage lesion larger than 2.5 cm. [11] Further on, chances are high that after only 1 or 2 years of the surgery symptoms start to return as the fibrocartilage wears away, forcing the patient to reengage in articular cartilage repair.