A public consultation has been launched by NICE over its draft guidance on a procedure to repair defects in knee cartilage.
The procedure, known as autologous chondrocyte implantation (ACI), involves collecting normal cartilage cells from inside the knee and growing them in a laboratory for several weeks to increase the number of cells. The cells are then implanted into the damaged area of the knee and sealed by a layer of tissue.
Draft guidance drawn up by NICE, the UK´s National Institute for Health and Care Excellence, recommends that ACI is used only in research for the time being. The organisation believes that more evidence is needed on how well the procedure works in the long term and its cost-effectiveness.
Cartilage damage in the knee can be caused by sports or other injury, or by arthritis. It can also appear suddenly for no apparent reason. Because cartilage has no blood or nerve supply, it has a limited ability to repair itself when damaged.
Professor Carole Longson MBE, director of the NICE centre for health technology evaluation, commented: “Knee cartilage damage can have a significant impact on a person´s life, employment and social activities. It´s estimated that every year in the UK, around 10,000 people need treatment for cartilage damage. Between 200 and 500 of these have cartilage defects suitable for autologous chondrocyte implantation.”
Longson went on to describe ACI is “a promising technology” but said that at the moment there is insufficient evidence to support a conclusion on the long-term effectiveness of its use.
As a result, the independent Appraisal Committee decided not to recommend ACI for routine use of NHS resources, but wanted to encourage further research – for example, clinical trials and observational studies – to generate more evidence on the effectiveness of the procedure.