Autologous Minced Cartilage Implantation for Treatment of Chondral and Osteochondral Lesions in the Knee Joint: An Overview

Abstract

Cartilage defects in the knee are being diagnosed with increased frequency and are treated with a variety of techniques. The aim of any cartilage repair procedure is to generate the highest tissue quality, which might correlate with improved clinical outcomes, return-to-sport, and long-term durability. Minced cartilage implantation (MCI) is a relatively simple and cost-effective technique to transplant autologous cartilage fragments in a single-step procedure. Minced cartilage has a strong biologic potential since autologous, activated non-dedifferentiated chondrocytes are utilized. It can be used both for small and large cartilage lesions, as well as for osteochondral lesions. As it is purely an autologous and homologous approach, it lacks a significant regulatory oversight process and can be clinically adopted without such limitations. The aim of this narrative review is to provide an overview of the current evidence supporting autologous minced cartilage implantation.

Minced Cartilage Implantation for a Cystic Defect on the Femoral Head—Technical Note

“…Recently, Salzman et al published an overview of how chondral and osteochondral lesions in the knee joint can be treated by autologous minced cartilage implantation. 12 The basic principle is the activation of the chondrocytes through to fragmentation of cartilage tissue, leading to migration and development of extracellular matrix. The result is a hyaline-like chondral repair.…”

“…24 The arthroscopic approach is intriguing for the patients, as the procedure is obviously less invasive and has a shorter hospital stay and smaller scars. The AutoCart technique has been used in the 12 and ankle arthroscopy. 25 While a surgical hip dislocation is more invasive compared to the arthroscopic technique, exposure of the a given cartilage lesion is easier, and cartilage repair may, therefore, be simpler, as in the presented case with a parafoveal defect.…”

“…In knee surgery, minced cartilage implantation (MCI) has recently evolved as an alternative treatment for chondral lesions. 11,12 This technique was first described in 1983 13 and became popular again, in recent years, while showing good quality of repair tissue and promising short-term clinical results. 11,14 Fragmentation of healthy cartilage appears to activate chondrocytes that proliferate and a de novo extracellular matrix production.…”

“…11,14 Fragmentation of healthy cartilage appears to activate chondrocytes that proliferate and a de novo extracellular matrix production. 12 Although ACI includes two staged interventions (i.e., harvesting in a first stage followed by culturing of the cartilage with implantation of the cartilage graft in a second step), the MCI is performed as a one-stage procedure.…”

Minced Cartilage Procedure for One-Stage Arthroscopic Repair of Chondral Defects at the Glenohumeral Joint

“…7,8 Research is therefore focusing on joint-preserving methods such as arthroscopic debridement, 9 microfracture, 10 osteochondral autograft transfer 11 or allograft transplantation, 12 partial shoulder resurfacing, [13][14][15] and autologous chondrocyte implantation (ACI). 16 Minced cartilage implantation 17 is a technique that was first described in the early 1980s 18 but is now gaining more and more interest, especially in the field of knee surgery where first clinical trials support good outcomes. 19 It is a cost-effective procedure that brings autologous cartilage chips harvested from the defect itself, the surrounding defect wall, lose bodies, or nonweightbearing areas and brings them into the area of damage in a single-step open or arthroscopic approach.…”