ACI is not recommended for treating knee problems caused by damaged articular cartilage, unless it is used in studies that are designed to produce good-quality information about the results of the procedure. These results should include measuring any improvement in patients’ quality of life, and the benefits and risks of ACI over a long period of time.

If ACI is offered as part of a clinical study, the doctor should explain that there are uncertainties about the long-term benefits of this procedure and the possible risks, such as locking of the knee, infections and not being able to fully straighten the leg.

This guidance updates and replaces NICE technology appraisal 16 (published in December 2000).

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.