Osteochondral allograft (OCA) with autologous chondrocyte implantation (ACI)
Everything you need to know about OCA and ACI
My surgeon essentially saved my life as it was having that big an impact on me. It was my last hope. But it was a one-night stay, then I was home.
What is an osteochondral allograft?
An osteochondral allograft is a surgical graft used to repair damaged hyaline cartilage, most commonly in your knee, ankle, or shoulder.
One of the most successful surgical techniques used to perform the surgical graft is autologous chondrocyte implantation (ACI).
This involves a minor keyhole procedure to take a biopsy of the cartilage within your damaged knee. A biopsy is a medical procedure that involves removing a small tissue sample from your body for examination. The tissue sample is then examined under a microscope to identify abnormal cells and conditions. The biopsy is processed in a specialist laboratory and your own chondrocytes (cells), which we describe in more detail below, are grown within the laboratory. The process of growing these cells usually takes four to eight weeks. After enough cells have grown, a second operation is performed as part of ACI, during which these cells are implanted into the damaged area in your knee. The aim is that the cells repair the damage and promote natural healing and improved mobility.
The ACI has been proven to improve your symptoms and help heal your cartilage effectively.
What are chondrocytes?
Most joints in the human body contain a highly specialised structure called hyaline cartilage.
Hyaline cartilage is a type of connective tissue found in various parts of your body. It is characterised by a smooth, glassy appearance, which is why it's called "hyaline," derived from the Greek word hyalos, meaning "glass."
The hyaline cartilage coats the end of your bone as a protective layer. Its properties make it a very low friction surface which allows your joint to move easily and painlessly. The hyaline cartilage is often referred to as ‘articular cartilage’ as it forms the articulating surface. "Articulating" refers to the process of two or more bones coming together to form a joint.
Hyaline cartilage is made by specialised cells called chondrocytes. These cells are very unusual in that unlike most cells within your body, they have no blood supply. Cells usually need a blood supply to survive but the chondrocytes obtain all they need from the fluid within your knee, known as synovial fluid.
Why might you need an osteochondral allograft?
Hyaline cartilage is susceptible to damage over time cause by arthritis or injury. Unlike lots of cells within your body, chondrocytes are not very good at replicating, so hyaline cartilage does not heal fast naturally. Damage to hyaline cartilage in your knee can cause ongoing symptoms of pain, stiffness, swelling and loss of joint function.
The situation is made even worse as the damaged area doesn’t function properly, meaning more stress is placed on the surrounding normal areas of hyaline cartilage in your knee. This can lead to progressive damage to areas that were previously healthy, resulting in osteoarthritis.
Injury to the hyaline cartilage is known as chondral damage. It can occur by itself or often with impact injury to the bone, which sits under the damaged surface. Damage caused by impact injury is known as osteochondral damage.
What our patients have to say at Thornbury Hospital
The first person to have ACI at Thornbury Hospital was Michael Kay. At aged 18, Michael was involved in a serious motorbike accident. He suffered two broken legs and a shattered knee which left him in constant pain.
Michael told us; “A couple of years later I went to see a specialist on the NHS as it was just debilitating. It was horrendous. I needed painkillers every day and I hate taking painkillers because of the side effects. I couldn’t really do anything anymore. I used to play 5-a-side with family and friends but that was impossible after the accident.”
Michael explained further how the success of the surgery has transformed his life:
“Even now, I’m only eight weeks post-op and I feel 10-times better. Not pain-free yet, but so much better. It’s like the surgeon’s put WD40 in my knee. It’s no contact sports for nine months and no load bearing until December, just strictly physiotherapy at the moment to build the muscles up.”
Book your consultation today
We offer private consultations and treatment options for cartilage damage, including both OCA and ACI.
To find out more information, book an appointment online with our consultant orthopaedic surgeon Mr Paul Sutton or Mr Matthew Hampton.
Content reviewed by Mr Paul Sutton (Consultant Orthopaedic Surgeon)
Tags
Sign up to our newsletter
How do I book an appointment?
If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.