| Summary: | RESEARCH QUESTION: The aim of the present investigation is the benefit assessment of the method of autologous chondrocyte implantation (with a periosteal flap, collagen-covered, matrix-induced) compared with standard treatment in adult patients with a specific symptomatic cartilage defect of the knee without advanced osteoarthritis. The focus of the assessment was on patient-relevant outcomes. CONCLUSION: When all 3 procedures of autologous chondrocyte implantation are considered together (matrix-induced [M-ACI], collagen-covered [ACI-C], with a periosteal flap [ACI-P]), the data provide no hint of benefit or harm versus standard treatment for any of the outcomes. At the medium-term time of analysis (11 to 24 months), heterogeneity between ACI procedures was evident for a large proportion of results, so each was considered separately In the 7 studies comparing M-ACI with standard treatments, beneficial effects in favour of M-ACI were shown for the outcomes of function and health-related quality of life. Although the effects do not reach a clinically relevant magnitude, together with a qualitative examination of all other outcomes it can be assumed that M-ACI has a benefit at least comparable to that of current standard treatments. Within each of the 2 studies comparing ACI-C and ACI-P with standard treatments, 1 study showed a statistically significant effect in favour of ACI-C for 1 outcome (treatment failure). However, no data on the harm of ACI-C are available from the studies, and all other outcomes on both ACI procedures show partly numerically inconsistent results. Therefore, the data provide no hint of a benefit or harm of ACI-C and ACI-P, and it cannot be estimated with sufficient certainty whether there is a benefit comparable to that of standard treatment. The results of the 3 studies comparing the ACI procedures in pairs do not contradict the assessment presented above
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