Autologous Chondrocyte Transplantation / Implantation Versus Existing treatments


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Chondral defects
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WHY ACTIVE?

There is no standard treatment for symptomatic chondral or osteochondral defects in the knee. Many patients can be treated successfully by straightforward arthroscopic washout or debridement but if such treatment fails to relieve symptoms, other techniques such as microfracture or mosaicplasty might by used in an attempt to restore articular cartilage.

Autologous chondrocyte implantation (ACI) is a more expensive technique requiring two surgical procedures and has a longer rehabilitation period than other techniques. By implanting healthy cartilage cells over the chondral lesion ACI has the potential to restore damaged cartilage if the cells can then grow and fill the lesion with hyaline cartilage. However, as yet ACI is still under review and is not routinely available in the NHS. The effectiveness of ACI needs to be compared with the alternative treatments through randomised trials like ACTIVE with a long-term follow-up as recommended by the National Institute of Clinical Excellence (NICE)

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ACTIVE is being carried out by the Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust in collaboration with the University of Birmingham Clinical Trials Unit and Health Economics Facility. The trial is funded by the Medical Research Council and administrated by Keele University.