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Advanced cartilage regeneration surgery

STACi

From £28,000
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STACi (Scaffold-based Tissue-engineered Autologous Chondrocyte Implantation) is an advanced cartilage regeneration procedure that uses your own cartilage cells, grown on a three-dimensional scaffold, to rebuild large areas of damaged cartilage in the knee. It represents the next generation of cell-based cartilage treatment and is currently only available at London Cartilage Clinic in the UK.

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Arthroscopic view during cartilage procedure

Why STACi exists and what it solves

Large cartilage defects present a clinical challenge. Microfracture works for small areas but produces fibrocartilage rather than the durable hyaline cartilage the joint needs. OATS is limited by the amount of donor tissue available from your own knee. Standard ACI and MACI improved on this but had limitations in defect size and tissue quality.

  • Treats larger defects than OATS, microfracture, or standard cartilage grafting can address.
  • The scaffold provides structural support while your own cells regenerate hyaline-like cartilage.
  • Designed for patients who are too young or too active for joint replacement.

STACi fills the gap between simpler cartilage procedures and joint replacement. For patients with significant cartilage loss who want to preserve their own knee, it offers a biological solution where other techniques fall short.

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The procedure and what to expect

STACi involves harvesting your own cartilage cells, expanding them in a specialist laboratory, seeding them onto a biocompatible scaffold, and implanting the construct into the prepared defect site in the knee.

  • Cartilage biopsy taken arthroscopically (keyhole) in the first stage.
  • Cells cultured and seeded onto the scaffold over several weeks.
  • Scaffold implanted into the defect through a small incision, secured in place to integrate.

Rehabilitation is carefully staged to protect the regenerating tissue. The scaffold gradually remodels as your own cartilage matures, with the goal of creating a durable, functional joint surface that can withstand the demands of an active life.

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Surgeon performing advanced cartilage implantation

You may have more options than you think

Most patients have more treatment options than they have been told

At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.

Preserve

Protect what you have. Slow degeneration and manage symptoms.

Repair

Fix specific damage. Torn tissue, unstable joints, structural problems.

Regenerate

Rebuild lost tissue. Biological treatments that stimulate new growth.

Replace

When other options are exhausted. Joint replacement as a last resort.

Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.

Explore Knee Options
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Frequently Asked Questions

What does STACi stand for?

STACi stands for Scaffold-based Tissue-engineered Autologous Chondrocyte Implantation. It is a next-generation evolution of the original ACI (autologous chondrocyte implantation) technique, using an advanced scaffold to support cartilage cell growth over larger defect areas.

How is STACi different from standard ACI or MACI?

Traditional ACI cultures cartilage cells and reimplants them under a periosteal patch. MACI improved on this by using a collagen membrane. STACi goes further by implanting the cells within a three-dimensional scaffold that provides structural support during regeneration, allowing treatment of larger and more complex defects with better tissue quality.

Who is a good candidate for STACi?

STACi is suited to patients with significant focal cartilage loss in the knee who are too young or too active for joint replacement. It is particularly relevant for patients with defects larger than what OATS or microfracture can address, typically greater than two to four square centimetres.

Why is STACi only available at London Cartilage Clinic?

STACi requires specialist surgical expertise, access to tissue engineering facilities, and a specific regulatory framework. Professor Lee and the team at London Cartilage Clinic have developed the protocols and infrastructure necessary to offer this procedure, making it the only centre in the UK where STACi is currently performed.

What is the recovery time after STACi?

Recovery is staged to protect the regenerating cartilage. Weight-bearing is restricted for six to eight weeks with crutches. Range of motion exercises begin early under physiotherapy guidance. Return to low-impact activity is expected from four to six months, with higher-impact sport from nine to twelve months depending on the size and location of the defect.

Is STACi a single procedure or does it require multiple stages?

STACi can be performed as a single-stage or two-stage procedure depending on the clinical situation. In the two-stage approach, cartilage cells are harvested arthroscopically, cultured over several weeks, and then reimplanted on the scaffold. In some cases, a single-stage approach using fresh cartilage tissue is possible.

Still have more specific concerns?

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