Letters to the Editor   |    
Chris R. Gooding, MRCS; G. Bentley, DSc, ChM, FRCS
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In support of their research for or preparation of this work, one or more of the authors received grants or outside funding from Johnson and Johnson. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Nov 01;88(11):2538-2538
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To The Editor:We read with interest the article "Autologous Cultured Chondrocytes: Adverse Events Reported to the United States Food and Drug Administration" (2006;88:503-7), by Wood et al. While the authors did allude to some of the limitations of passive reporting systems, we felt that they warrant further emphasis.In the paper, it is not clear what the pretransplantation selection criteria for the patients were. At present, most centers use the technique for isolated osteochondral defects and consider any evidence of degenerative changes in the joint as a contraindication. Also, to prevent recurrent chondral injury, a careful evaluation for predisposing factors or concomitant injuries must be undertaken. Minas and Nehrer13 reported in their review that any tibiofemoral malalignment, ligamentous instability, or bone insufficiency must be corrected prior to, or at the time of, cartilage repair. For example, rupture or laxity of the anterior cruciate ligament may result in abnormal translation and rotation of the femur on the tibia and shearing of the chondrocyte graft. Thus, proper patient selection is crucial to the success of this procedure, and it is not a "one size fits all" technique.
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