Autologous chondrocyte implantation (ACI)

Coverage decision: Not covered (Effective: August 1, 2016).

Autologous chondrocyte implantation (ACI) is not a covered procedure for Washington States’ injured workers, effective on August 1, 2016.  For further information, please refer to Surgical Guideline for Work-related Knee Injuries.

ACI is a two-stage technique done to treat localized cartilage defects in the femoral condyle, trochlea, or patella. The first stage is the harvesting and culturing of cartilage cellsIn the second stage, these cells are implanted into the area of cartilage defect, with the goal of stimulating generation of cartilage in hopes of preventing or slowing the onset of osteoarthritis. However, current scientific evidence shows that ACI is inferior to other procedures such as osteochondral autograft/allograft transplantation (OAT) and marrow stimulation procedures (e.g. microfracture, subchondral drilling, or abrasion arthroplasty) in terms of effectiveness and success rate.

Regulatory authority and related information

• Treatment requiring authorization. WAC 296-20-01002.
• Utilization review WAC 296-20-024.
• Medical coverage decisions. WAC 296-20-02700-02850.