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Sunday April 24, 2005

Regenerating own cells

INJURIES to the cartilage are problematic primarily because cartilage cannot self-repair. Such injuries can result in degenerative changes and osteoarthritis if left untreated. 

Autologous chondrocyte implantation (ACI) 

This is a clinically proven application of tissue engineering for the treatment of full thickness articular cartilage defects. Basically it involves regenerating cartilage using the patientís own (autologous) cartilage cells (chondrocytes). 

The technique was developed in Europe, USA and Australasia and has proven clinical efficacy and long-term durability. 

The resultant cartilage exhibits similar physiological and biomechanical properties as the original cartilage, and the patient can return to pre-injury activities. 

In the long-term, the procedure eliminates the need for further surgical intervention and joint replacement. 

Periosteum covered ACI (PACI) 

This is a technique where the cells are implanted beneath live autologous periosteum: 

Stage 1: Cartiage biospy is taken from patient.
Stage 2: Chondrocytes (cartilage cells) are isolated and multiplied in sterile culture laboratory (four weeks).
Stage 3
Patient selection 

The technique is suitable for:
1. Cartilage damage caused by direct injury (for example sports injury)
2. Aged 15 - 55 years old
3. Lesion sizes ranging from 1 - 10cm2
4. Multiple lesions acceptable
5. Most lesions of the knee and ankle(potential to extend to shoulder, hip and elbow)
It is not suitable for:
1. Widespread cartilage damage
2. Osteoarthritis (slow degeneration)
3. Rheumatoid arthritis (inflammatory disease)
4. Medication likely to compromise cartilage proliferation (steroids or chemotherapy). 

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