Chondral Injury of the Knee: Current Controversies in 2019 (AANA19)-Cell Based Cartilage Restoration-Dr. Andreas H. Gomoll, M.D.

Video Transcription

Video Summary

Dr. Gamal discusses 30 years of successful cell-based cartilage repair therapies, focusing on Autologous Chondrocyte Implantation (ACI) and particulated juvenile allograft cartilage (PJAC). Cell-based therapies include soft tissue grafts that mature over 2-5 years, restoring cartilage consistency and enabling return to high-impact sports. Advantages include moldability, suitability for complex joint surfaces like the patellofemoral joint, and arthroscopic application, especially with newer techniques like MACI. Downsides involve vulnerability to shear stress, longer recovery, need for intact subchondral bone, and high costs with insurance challenges. PJAC suits smaller defects or as an adjunct to allografts, while MACI offers longer-term, well-documented outcomes up to 20 years, showing 75-80% graft survival and arthroplasty-free longevity. Patient selection depends on biomechanics and meniscus status. Overall, cell-based repair provides a rigorously studied, versatile option for cartilage defects, with MACI preferred for primary treatment and PJAC mainly as secondary support.

Asset Caption

Instructional Course Lecture: Chondral Injury of the Knee: Current Controversies in 2019

Keywords

Autologous Chondrocyte Implantation

Particulated Juvenile Allograft Cartilage

Cell-based cartilage repair

MACI technique

Cartilage defect treatment