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Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions

Autologous chondrocyte implantation may be considered medically necessary for the treatment of disabling full-thickness articular cartilage defects of the knee caused by acute or repetitive trauma when all of the following criteria are met:Adolescent patients should be skeletally mature with documented closure of growth plates (eg, ≥15 years). Adult patients should be too young to be considered an appropriate candidate for total knee arthroplasty or other reconstructive knee surgery (eg, <55 years) Focal, full-thickness (grade III or IV) unipolar lesions of the weight-bearing surface of the femoral condyles, trochlea, or patella at least 1.5 cm2 in size Documented minimal to absent degenerative changes in the surrounding articular cartilage (Outerbridge grade II or less), and normal-appearing hyaline cartilage surrounding the border of the defect Normal knee biomechanics or alignment and stability achieved concurrently with autologous chondrocyte implantation. Autologous chondrocyte implantation for all other joints, including the talar, and any indications other than those listed above is considered investigational.

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