Autologous chondrocyte implantation: a systematic review

OBJECTIVE: To critically analyze the existing literature relating to autologous chondrocyte implantation (ACI) and thereby to ascertain whether the technique is clinically effective and safe. METHODS: Using predefined criteria, we searched a number of automated databases, such as MEDLINE, EMBASE, Cochrane, CRD, etc., for relevant articles, which were then analyzed by two independent reviewers. RESULTS: Three clinical trials and nine case series were evaluated. The clinical trials yielded no evidence that ACI was superior to the therapeutic alternatives with which it was compared. In contrast, the case series revealed an improvement in patients. However, as with the clinical trials, the follow-up periods were usually very short. In general, few adverse effects were observed, indicating that ACI is a safe technique. CONCLUSION: Available data afford no evidence that ACI is more effective than other conventional techniques in treating chondral lesions of the knee.