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Introduction
The autologous chondrocyte transplantation has been widely used to treat articular cartilage defects. The articular cartilage is composed of cells, chondrocytes and extra cellular matrix. The chondrocytes are specialized in the matrix synthesis and turnover, but these cells do not normally proliferate in vivo. These biological conditions of the cartilage tissues difficult cartilage lesion repair. Many times cartilage lesions are filled with mesenchymal cell, or even fibroblastic cells, and the repair tissue formed shows fibrous characteristics. The autologous chondrocyte transplantation, based on a cell culture technique, allows the chondrocyte proliferation. Once the cultured cells are transplanted back into the patient they are able to regenerate the hyaline cartilage, with composition and biomechanics very similar to the original tissue. This biological option for cartilage treatment was introduced for the first time in a Latin America country to treat a full deep cartilage defect of the femoral condyle.
Methods
LK, women, thirty-nine years old showed osteochondral lesion, level II, troclhea femoral and patellar chondromalacea. Previous surgeries and conventional treatments were unsuccessful. Autologous chondrocyte transplantation was indicated. During arthroscopy procedure the articular surfaces were regularized and cartilage samples were obtained form a non-weigh bearing area. The autologous chondrocyte transplantation was made 20 days after the arthroscopy. The follow up was made using MRI.
Results and Discussion
The 10 months follow-up of the full chondral defect of the femoral condyle treated with autologous chondrocyte transplantation showed satisfactory clinical results. The second arthroscopy made showed periosteum integration and the appearance of normal cartilage. The tissue formed at the lesion site was soft, indicating condromalacea, level I. The MRI showed a cartilage formation at the site of the lesion.
Conclusion
The conclusion that the autologous chondrocyte transplantation can be safety carried on in Brazil came from the satisfactory clinical evaluation of the patient, the MRI images and the second arthroscopy showing graft integration. Other clinical cases are in progress to extend the data.
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