Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.1006
Peer-review started: May 25, 2015
First decision: August 4, 2015
Revised: September 23, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 18, 2015
AIM: To investigate the state of the art regarding Cartilage Autograft Implantation System (CAIS) or Particulated Juvenile Allograft Cartilage (PJAC).
METHODS: The authors searched the English literature regarding CAIS and PJAC. The search strategy was: (particulated cartilage) OR autologous cartilage fragments. All basic science articles were included. Clinical articles with less than 10 patients treated and less than 6 mo of follow-up were excluded. With these criteria, a total of 17 articles were available for the present review.
RESULTS: PJAC and CAIS are relatively novel techniques for cartilage repair. Good basic science evidence was described to support the concept. Although the preliminary clinical reports show encouraging results, clinical data are still limited, especially for CAIS. The indications for both techniques need to be precisely defined (age of the patients, size of the lesion, and involvement of the subchondral bone), together with other debated issues.
CONCLUSION: In conclusion, the authors can state that encouraging preliminary results are available for both techniques. However, further studies are necessary to precisely determine the indications, surgical techniques, and long term outcomes for PJAC and CAIS.
Core tip: In this systematic review regarding Cartilage Autograft Implantation System (CAIS) and Particulated Juvenile Allograft Cartilage (PJAC), basic science and clinical articles with more than 10 patients treated and more than 6 mo of follow-up were included. A total of 17 articles were available for the present review. Good basic science evidence in vitro and in vivo was described to support the concept of CAIS. Only one level II paper reported the clinical results of the CAIS technique. On the other hand, little basic science evidence and 4 preliminary clinical trials are available regarding the PJAC technique. CAIS and PJAC represent promising single step solutions for cartilage restoration with hyaline-like repair. However, many controversies still exist regarding both techniques, including the indications (age of the patients, size of the lesion, and involvement of the subchondral bone).