Autologous Chondrocyte Implantation (ACI) for Cartilage Defects of the Knee Using Novocart 3D and Novocart Inject

Ever since autologous chondrocyte implantation (ACI) has been introduced, there have been important advancements and progress leading to a more reliable and more standardized application of this technology. While first-generation ACI followed the principle of a cell-suspension being injected under an autologous periosteum patch, second and third generation of ACI are characterized by the use of biomaterials, either using a cell-suspension (2 nd generation) or a combination of cells and the biomaterial (3 rd generation). Due to easier handling and improved clinical outcome, 3 rd generation ACI has become the gold standard for the use of ACI at this time. The present chapter focuses on the Novocart® 3 rd generation ACI products. While Novocart® 3D uses a collagen membrane and therefore a implantable biomaterial, Novocart® Inject is a hydrogel-based ACI product which can be injected into the cartilage defects. Both products are currently under way for central European market authorization by the European Medicinal Agency (EMA), additionally a FDA-approval trial is under way for Novocart® 3D. Products characteristics, indication, surgical technique and clinical outcome are summarized in the present chapter.