Selected Instructional Course Lecture   |    
Autologous Chondrocyte Implantation
Deryk G. Jones, MD1; Lars Peterson, MD, PhD2
1 Ochsner Clinic Foundation, Section of Sports Medicine, 1514 Jefferson Highway, New Orleans, LA 70121. E-mail address: djones@ochsner.org
2 Gothenburg Medical Center Gruvgaten 6, SE-421 Västra, Frölunda, Gothenburg, Sweden
View Disclosures and Other Information
Look for this and other related articles in Instructional Course Lectures, Volume 56, which will be published by the American Academy of Orthopaedic Surgeons in February 2007:
• "Technical Aspects of Osteochondral Autograft Transplantation," by Anthony Miniaci, MD, FRCSC, and Paul A. Martineau, MD, FRCSC
In support of their research for or preparation of this manuscript, one or more of the authors received a research grant from Genzyme Bio-surgery. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (consultant for Genzyme Biosurgery). A commercial entity (Genzyme Biosurgery) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2007 in Instructional Course Lectures, Volume 56. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Nov 01;88(11):2501-2520
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Injuries to joint surfaces can result from acute high-impact or repetitive shear and torsional loads to the superficial zone of the articular cartilage architecture. Direct arthroscopic visualization has suggested that the prevalence of isolated, focal articular cartilage defects is approximately 5%1,2. In a retrospective review of more than 31,000 arthroscopic procedures, Curl et al. found a 63% prevalence of chondral lesions with an average of 2.7 lesions per knee1. Older patients had more lesions. Curl et al. found grade-IV lesions (according to a modification of the Outerbridge classification system3) in 20% of the patients, but only 5% of the individuals who had such a lesion were less than forty years old. Three out of four of the patients had a solitary lesion. A prospective study demonstrated chondral or osteochondral lesions in 61% of the patients, whereas focal defects were found in 19%2; these percentages are similar to those found in the retrospective analysis1. In the prospective assessment, the mean defect size was 2.1 cm2. A single, well-defined International Cartilage Repair Society (ICRS) grade-III or IV defect4 (at least 1 cm2) accounted for 5.3%, 6.1%, and 7.1% of the arthroscopic procedures in patients younger than forty, forty-five, and fifty years old, respectively2. The prevalence of articular lesions secondary to work-related and sports activities has been reported to be as high as 22% to 50% in other studies5,6. Such injuries alone or in combination with ligamentous instability, meniscal lesions, or mechanical malalignment can be debilitating.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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