Autologous chondrocyte implantation and anteromedialization in the treatment of patellofemoral chondrosis jack farr, 11, md aorth01ndy knee care institute, 5255 e stop 11 road. Autologous chondrocyte implantation aci, a promising modality for repairing full thickness cartilage defects, requires 2 consecutive. Autologous chondrocyte transplantation act, also known as autologous chondrocyte implantation. Autologous chondrocyte implantation carticel mpm 3. There is no scientific literature to support the use of autologous chondrocyte implantation for all other. Matrixinduced autologous chondrocyte implantation and. After several visits to sweden in the early 1990s, i adapted the technique described by peterson and coworkers 1 figure 71. In cases where the depth of the defect exceeds 8 10 mm, bone grafting is planned either at the time of the biopsy, as a separate procedure, or at the time.
The matrixinduced autologous chondrocyte implantation maci procedure is a 2 stage procedure. Inclusion criteria patients treated with autologous chondrocyte implantation, who had symptomatic incapacitating injuries involving the full thickness of articular cartilage of the knee, from. Read this important information any person who knowingly files a request for authorization of coverage of a medical procedure or service with the intent to. Autologous chondrocyte transplantation is known as autologous chondrocyte implantation aci in north america. When service or procedure may not be covered when the criteria above are not met.
Washington state department of labor and industries. Effective january 1, 2020, this form replaces all other autolougous chondrocyte implantation precertification information request documents and forms. Autologous chondrocyte implantation for focal articular. Geha osteochondral authorization form including grafting. Autologous chondrocyte implantation, knee arthroscopic harvesting of chondrocytes from the knee is reported using cpt code 29870. One such technique is autologous chondrocyte implantation. This procedure is done as an open procedure which means that you will have a larger incision which will measure anywhere between 36 inches in length. Biology, histology, and clinical outcomes craig robert willers bsch1, mmedsc this thesis was submitted as fulfillment of the requirements for the degree of doctor of philosophy in medical science 2008. Mri and indirect mrartro knee in patients treated with. Aci, is a twostep surgical procedure for treatment of. Maci is a nextgeneration approach to traditional aci that provides the benefit of autologous cells and guided tissue regeneration using a biocompatible collagen scaffold. Maci is a cellular sheet that consists of autologous chondrocytes seeded on a 3 x 5 cm, resorbable porcine type iiii collagen membrane. Autologous chondrocyte implantation for treatment of isolated cartilage defects of the knee has become well established.
The procedure is performed with the patient supine. Autologous chondrocyte transplantation or implantation. The assessment concluded that it is not possible to draw definitive conclusions about the clinical effectiveness of this technology based on available literature. Maci, matrixinduced autologous chondrocyte implantation.
Successful repair of articular cartilage lesions of the human knee by autologous chondro cyte implantation aci was first reported. Maci autologous cultured chondrocytes on porcine collagen. The technique has been used extensively since it was introduced in the 1980s. Matrixinduced autologous chondrocyte implantation maci.
Autologous chondrocyte implantation aci autologous chondrocyte implantation aci is a relatively new, stateoftheart procedure used to treat isolated fullthickness down to bone articular cartilage defects of the knee. Autologous chondrocyte implantation is a biomedical treatment that repairs damages in. It has been approved by the food and drug administration for cartilage defects located at the end of the femur bone thigh. To describe the autologous chondrocyte implantation aci sandwich technique with autologous bone grafting abg and compare it with abg alone for restoration of the osteochondral unit. The goal of aci is to allow people suffering from articular cartilage damage to return to their old. Autologous chondrocyte implantation aci surgery tricare covers aci surgery for the repair of clinically significant, symptomatic, cartilaginous defects of the femoral condyle click to close a pair of round, bony protrusions on each side of the femur bone in the thigh. Matrixinduced autologous chondrocyte implantation and autologous chondrocyte. The first generation of aci utilized a periosteal patch to contain the cultured chondrocyte solution within the defect. The american medical association ama has issued a unique and permanent category i cpt code for autologous chondrocyte implantation aci, effective january 1, 2005. Autologous chondrocyte implantation can provide a longterm solution in more than 70% of young patients of a difficulttotreat group with large chronic articular cartilage lesions. Aci provides pain relief while at the same time slowing down the progression or considerably delaying partial or total joint replacement knee replacement surgery. Second and thirdgeneration techniques include combinations of. Autologous chondrocyte implantation aci is considered medically necessary for the repair of.
Revision surgery after third generation autologous chondrocyte implantation in the knee thomas r. Autologous chondrocyte implantation aci using a collagen scaffold matrixinduced aci. The midterm to longterm outcomes in patients after the treatment for ocd and avn will be reported and compared. Autologous chondrocyte implantation aci surgery tricare. Autologous chondrocyte implantation aci is a technique that involves the cultivation of chondrocytes in vitro, utilising a twostage operative approach that is usually spread over approximately five weeks. Background autologous chondrocyte implantation aci is an established method for treating cartilage defects in the knee of adult patients. Autologous chondrocyte implantation aci was first developed in the late 1980s for the treatment of articular cartilage defects in the knee. Autologous chondrocyte implantation policy guidelines for smaller lesions e.
Autologous means that the implanted cells come from you, and the term chondrocyte is the name for the type of cartilage cells that repair the damaged area, known as a lesion. Autolougous chondrocyte implantation precertification. Autologous chondrocyte implantation aci, atc code m09ax02 is a biomedical treatment that repairs damages in articular cartilage. Imageguided chondrocyte harvesting for autologous chondrocyte. What will happen during my autologous chondrocyte implantation. Autologous chondrocyte implantation for all other joints, including patellar and talar, and any indications other than those listed above is considered investigational.
Pcfx autolougous chondrocyte implantation precertification. Maci is used for the repair of symptomatic cartilage damage of the adult knee. Second and thirdgeneration techniques include combinations of autologous chondrocytes, scaffolds, and growth factors. The presence of disabling pain, swelling andor locking or catching of the knee that remains unresponsive to. Matrixinduced autologous chondrocyte implantation maci the purpose of the maci procedure is to help regenerate health articular cartilage in the knee to reduce the inflammatory response that often leads to pain, swelling and loss of motion. Lars peterson md and coworkers first developed the aci technique in sweden during the 1980s to delay the onset of degenerative osteoarthritis by allowing the regeneration of hyalinelike cartilage. Autologous chondrocyte transplantation for the treatment of cartilage defects of the knee is considered medically necessary when the abovenoted medical criteria are met.
Mark powell most trochlearpatellar defect repairs are performed in combination with a distal realignment if painfree, weight bearing is restricted for the. There is a specific cpt category i code for aci of the knee. Autologous chondrocyte implantation clinical coverage criteria. Autologous chondrocyte implantation aci for the treatment of full thickness articular cartilage defects of the knee may be considered medically necessary when all of the following criteria are met. Hyaline cartilage covers joint surfaces and plays an.
What links here related changes upload file special pages permanent link page. Autologous chondrocyte implantation trochleapatella rehabilitation protocol dr. This may not be a benefit on all plans or the plan may have broader or more limited benefits than those listed in these criteria. Bluecross blueshield association bcbsa, technology evaluation center tec. Autologous chondrocyte implantation aci information. Pdf matrixinduced autologous chondrocyte implantation. Autologous chondrocyte implantation aci and osteochondral autograft transfer system oats. The active ingredients of maci are the autologous cultured chondrocytes and porcine type iiii collagen. Autologous chondrocyte implantation aci or transplantation is a form of tissue engineering that creates a. There is a hcpcs code for the autologous cultured chondrocyte implant j7330. Including grafting and autologous cultured chondrocyte implantation purpose of this form you can use this form to initiate your precertification request. This procedure is done as an open procedure which means that you will have a larger incision which will measure anywhere between 3.
Autologous chondrocyte implantation aci, a promising modality for repairing fullthickness cartilage defects, requires 2 consecutive. Autologous chondrocyte implantation sandwich technique. Indianapolis, in 46237, usa blndiana university school of medicine, department of surgery, 541 clinical drive, suite 600, indianapolis, in 46202, usa. Autologous chondrocyte implantation aci patient education.
Niethammer 0 siegfried valentin 0 andreas ficklscherer 0 mehmet f. Evolution and current role of autologous chondrocyte implantation. Autologous chondrocyte implantation aci involves harvesting chondrocytes from healthy tissue, expanding the cells in vitro, and implanting the expanded cells into the chondral defect. Autologous chondrocyte implantation using chondrosphere. Autologous chondrocyte implantation page 5 of 25 050120. Autologous chondrocyte implantation improves patellofemoral cartilage treatment outcomes jack farr, md many patients with patellofemoral pain have multiple knee disorders, such as chondral defects, malalignment, and ligament insufficiency. Matrixinduced autologous chondrocyte implantation maci in the knee. Sever e, disabling pain and a loss of knee function that interferes with the ability to. Autologous chondrocyte transplantation of the knee. The midterm to longterm outcomes in patients after the treatment for ocd and avn will be. Aci is a technique for regenerating hyaline cartilage in a diseased or damaged area of a joint through the implantation of cartilage cells. Autologous chondrocyte implantation clinical coverage criteria page 3 of 5 effective 11012019 osteochondral allograft is recommended for defects greater than 10 cm2 9.
Rehabilitation after autologous chondrocyte implantation for isolated. Autologous chondrocyte implantation in the adolescent knee. Since its first description by brittberg in 1994, 1 chondrocyte implantation also known as chondrocyte transplantation has been performed in more than 15,000 patients worldwide and many studies have clinically validated this technique as a reliable method for biologic restoration of. Autologous chondrocyte implantation ucare considers autologous chondrocyte implantation aci of the knee as medically necessary for articular cartilage defects when all of the following criteria are met. Autolougous chondrocyte implantation precertification information request form section 4. Matrixinduced autologous chondrocyte implantation with. The second step of your surgical management is the autologous chondrocyte implantation. Autologous chondrocyte implantation aci involves harvesting chondrocytes from. Implantation for focal articular cartilage lesions effective 04182019 pdf icon. Autologous chondrocyte implantation aci is a technique that involves the cultivation. Demonstration of a technique for the treatment of osteochondral lesions of the femoral trochlea using a single maci scaffold and autologous bone grafting for a segmental osseous defect.
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