Abstract
Autologous chondrocyte implantation (ACI) is a surgical technique that is increasingly being used in the treatment of full-thickness defects of articular cartilage in the knee. It involves the arthroscopic harvesting and in vitro culture of chondrocytes that are subsequently implanted into a previously identified chondral defect. The aim is to produce a repair tissue that closely resembles hyaline articular cartilage that gradually becomes incorporated, restoring joint congruity. Over the long term, it is hoped that this will prevent the progression of full-thickness articular cartilage defects to osteoarthritis. This article reviews the indications and operative procedure performed in ACI. Magnetic resonance imaging (MRI) sequences that provide optimal visualization of articular cartilage in the post-operative period are discussed. Normal appearances of ACI on MRI are presented along with common complications that are encountered with this technique.
Similar content being viewed by others
References
Curl WW, Krome J, Gordon ES et al (1997) Cartilage injuries: a review of 31516 knee arthroscopies. Arthroscopy 13:456–460
Buckwalter JA (1998). Articular cartilage: injuries and potential for healing. J Orthop Sports Phys Ther 28(4):192–202
Brittberg M, Lindahl A, Nilsson A et al (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte implantation. N Engl J Med 331:889–895
Gillogly SD (2003) Treatment of large full thickness chondral defects of the knee with autologous chondrocyte implantation. Arthroscopy 19 Suppl 1:147–153
Mandelbaum BR, Gerhardt MB, Peterson L (2003) Autologous chondrocyte implantation of the talus. Arthroscopy 19:129–137
Koulalis D, Schultz W, Heyden M (2002) Autologous chondrocyte transplantation for osteochondritis dissecans of the talus. Clin Orthop395:186–192
Romeo AA, Cole BJ, Mazzocca AD et al (2002) Autologous chondrocyte repair of an articular defect in the humeral head. Arthroscopy 18:925–929
Bradley JP, Petrie RS (2001) Osteochondritis dissecans of the humeral capitellum. Clin Sports Med 20:565–590
Giannini S, Buda R, Grigolo B et al (2001). Autologous chondrocyte transplantation in osteochondral lesions of the ankle joint. Foot Ankle Int 22:513–517
Whittaker JP, Smith G, Makwana N et al (2005) Early results of autologous chondrocyte implantation in the talus. J Bone Joint Surg Br 87(2):179–183
Minas T, Peterson L (1999) Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med 18:13–44
Messner K, Maletius W (1996) The long–term prognosis for severe damage to weight–bearing cartilage in the knee: a 14-year clinical and radiographic follow-up in 28 young athletes. Acta Orthop Scand 67:165–168
Recht M, White LM, Winalski CS et al (2003) imaging of cartilage repair procedures. Skeletal Radiol 32:185–200
Recht MP, Bobic V, Burstein D et al (2001). Magnetic resonance of cartilage. Clin Orthop 391(Suppl):S379–S396
Potter HG, Linklater JM, Allen AA et al (1998) MR imaging of articular cartilage of the knee: a prospective evaluation utilizing fast spin-echo imaging. J Bone Joint Surg Am 80:1276–1284
Gold GE, Beaulieu CF (2001) Future of MR imaging if articular cartilage. Semin Musculoskel Radiol 5(4):313–327
Disler DG, McCauley TR, Kelman CG et al (1996) Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects of the knee: comparison with standard MR imaging and arthroscopy. AJR Am J Roentgenol 167:127–132
Minas T, Chiu R (2000) Autologous chondrocyte transplantation. Am J Knee Surg 13:41–50
Gillogly SD (2002). Autologous chondrocyte implantation: Complex defects and concomitant procedures. Oper Tech Sports Med 10:120–128
Marlovits S, Streissnig G, Resinger C et al (2004) Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging. European J Radiol 52:310–319
Haddo O, Mahroof S, Higgs D et al (2004) The use of chondrogide membrane in autologous chondrocyte implantation. Knee11(1):51–55
Briggs TWR, Mahroof S, David LA et al (2003) Histological evaluation of chondral defects after autologous chondrocyte implantation of the knee. J Bone Joint Surg Br 85B:1077–1083
Bartlett W, Flanagan AM, Gooding CR et al (2005). Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee. J Bone Joint Surg Br 87:640–645
Bartlett W, Gooding CR, Carrington RWJ et al (2005) Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft. J Bone Joint Surg Br 87:330–332
Azer NM, Winalski CS, Minas T (2004) MR imaging for surgical planning and postoperative assessment in early osteoarthritis. Radiol Clin N Am 42:43–60
Broderick LS, Turner DA, Renfrew DL et al (1994) Severity of articular cartilage abnormality in patients with osteoarthritis: evaluation with fast spin-echo MR vs. arthroscopy. AJR Am J Roentgenol 162:99–103
Bredella MA, Tirman PFJ, Peterfy CG et al (1999) Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol 172:1073–1080
Disler DG. (1997) Fat-suppressed three-dimensional spoiled gradient-recalled MR imaging: assessment of articular and physeal hyaline cartilage. AJR Am J Roentgenol 169:1117–1123
Recht MP, Piriano DW, Paletta GA et al (1996) Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patello-femoral articular cartilage abnormalities. Radiology 198:209–212
Wada Y, Watanabe A, Yamashita T et al. (2003) Evaluation of articular cartilage with 3D-SPGR MRI after autologous chondrocyte implantation. J Orthop Sci 8:514–517
Alparslan L, Winalski CS, Boutin RD et al (2001) Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskel Radiol 5:345–363
Kramer J, Recht MP, Imhof H et al (1994) Postcontrast MR arthrography in assessment of cartilage lesions. J Comput Assist Tomogr 18:218–224
Winalski CS, Aliabadi P, Wright RJ et al (1993) Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications. Radiology 187:179–185
Minas T, Peterson L (2000) Autologous chondrocyte transplantation. Oper Tech Sports Med 8:144–157
Peterson L, Minas T, Brittberg M et al (2000) Two to nine year outcomes after autologous chondrocyte transplantation of the knee. Clin Orthop 374:212–234
Yoshida S, Recht MP (2002) Postoperative evaluation of the knee. Radiol Clin N Am 40:113–1146
Tins BJ, McCall IW, Takahashi T et al (2005) Autologous chondrocyte implantation in knee joint: MR imaging and histologic features at 1-year follow-up. Radiology 234:501–508
Henderson IJ, Tuy B, Connell DA et al (2003) Prospective clinical study of autologous chondrocyte implantation and correlation with MRI at three and twelve months. J Bone Joint Surg Br 85:1060–1066
Yoshioka H, Stevens K, Hargreaves BA et al (2004) Magnetic resonance imaging of articular cartilage of the knee: comparison between fat-suppressed three-dimensional SPGR imaging, fat-suppressed FSE imaging, and fat-suppressed three-dimensional DEFT imaging, and correlation with arthroscopy. J Magn Reson Imaging 20(5):857–864
Roberts S, McCall IW, Darby AJ et al (2003) Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology. Arthritis Res Ther 5:60–73
Alparslan L, Minas T, Winalski CS (2001) Magnetic resonance imaging of autologous chondrocyte implantation Semin Ultrasound CT MRI 22:341–351
Brown WE, Potter HG, Marx RG et al (2004) Magnetic resonance imaging appearance of cartilage repair in the knee. Clin Orthop 422:214–223
Knutsen G, Engebretsen L, Ludvigsen TC et al (2004) Autologous chondrocyte implantation compared with microfracture in the knee. J Bone Joint Surg Br 86(3):455–464
Bahuard J, Maitrot R, Bouvet R et al (1998) Implantation of autologous chondrocytes for cartilaginous lesions in young patients. a study of 24 cases. Chirurgie 123:568–571
Richardson J, Caterson B, Evans E et al (1999) Repair of human articular cartilage after implantation of autologous chondrocytes. J Bone Joint Surg Br 81:1064–1068
Bentley G, Biant LC, Carrington M et al (2003) A prospective, randomized comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects of the knee. J Bone Joint Surg Br 85:223–230
Horas U, Pelinkovic D, Herr G et al (2003) Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. J Bone Joint Surg Br 85(2):185–192
Henderson I, Francisco R, Oakes B et al (2005) Autologous chondrocyte implantation for treatment of focal chondral defects of the knee – a clinical, arthroscopic, MRI and histologic evaluation. Knee 12(3):209–216
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
James, S.L.J., Connell, D.A., Saifuddin, A. et al. MR imaging of autologous chondrocyte implantation of the knee. Eur Radiol 16, 1022–1030 (2006). https://doi.org/10.1007/s00330-005-0051-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-005-0051-y