Autologous Chondrocyte Implantation

Having reviewd my brain (!!), I have a created a scientific pillar post. I intend to have an uber-technical one (below), and a more general, easy-to-understand one. These should be useful for driving traffic by vitue of the keywords contained in them. This is the technical one:

Osteoarthritis and Rheumatoid arthritis have completely different molecular origins, the latter being largely an auto-immune disease, the former having many origins, from simple mechanical defects to inflammatory.

Articular cartilage lesions, caused by trauma, osteochondritis disseccans or as a result of instability or abnormal loading are a common cause of disability, often associated with pain, reduction of joint mobility and loss of function, and can ultimately lead to osteoarthritis. Articular cartilage has a very limited intrinsic healing potential, related to the absence of vascularization and the presence of few and very specialized cells with low mitotic activity. Therefore, injury to the cartilage tissue still represents a major challenge for the orthopaedic surgeons.Traditional surgical techniques, that is palliative (e.g. lavage and debridement) or reparative options (e.g. bone marrow stimulation techniques), have shown variable success rates and carry a number of limitations. On the other hand, autologous chondrocyte implantation (injection of in vitro expanded autologous chondrocytes) has been proven to be clinically effective in the treatment of large, full thickness focal defects of the femoral condyle, including OCD. Recent evidence from prospective, controlled clinical studies comparing ACI with conventional treatments, in particular debridement, marrow stimulation techniques and mosaicplasty, suggests the superiority of ACI treatment, especially at long follow-up times. Despite the promising clinical results obtained so far, the use of ACI is associated with a number of limitations essentially correlated with the complexity of the surgical procedure, in particular the potential of cell leakage from the lesion site and the occurrence of periosteal hypertophy.Articular cartilage lesions, caused by trauma, osteochondritis disseccans or as a result of instability or abnormal loading are a common cause of disability, often associated with pain, reduction of joint mobility and loss of function, and can ultimately lead to osteoarthritis. Articular cartilage has a very limited intrinsic healing potential, related to the absence of vascularization and the presence of few and very specialized cells with low mitotic activity. Therefore, injury to the cartilage tissue still represents a major challenge for the orthopaedic surgeons.

Traditional surgical techniques, that is palliative (e.g. lavage and debridement) or reparative options (e.g. bone marrow stimulation techniques), have shown variable success rates and carry a number of limitations. On the other hand, autologous chondrocyte implantation (injection of in vitro expanded autologous chondrocytes) has been proven to be clinically effective in the treatment of large, full thickness focal defects of the femoral condyle, including OCD. Recent evidence from prospective, controlled clinical studies comparing ACI with conventional treatments, in particular debridement, marrow stimulation techniques and mosaicplasty, suggests the superiority of ACI treatment, especially at long follow-up times. Despite the promising clinical results obtained so far, the use of ACI is associated with a number of limitations essentially correlated with the complexity of the surgical procedure, in particular the potential of cell leakage from the lesion site and the occurrence of periosteal hypertophy.

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