1. Recruitment Recruitment is just 81 patients so far. To demonstrate to the MRC that this study is viable a big effort is required to reach the 200 target by October ‘06. Trondheim & Oswestry are neck & neck. Well done Swindon for getting set up and started so quickly. Warrington & Wrightington are off the starting blocks. Stockport, York & Weston- s-Mare are almost ready to start and more centres are close behind (it sounds like a horse race – I’ll be taking bets next!). Of our 81 patients so far: Previous procedureno. of patients Debridement42 Microfracture17 Washout8 Other 8 Drilling4 Mosaicplasty2 Intended standard arm* Microfracture66 Debridement7 Mosaicplasty5 Drilling3 Predicted size of defect (cm 2 )* <4.037 4.0-7.940 8.0+4 Age group* 0-2911 30-3933 40-4931 50+6 Mean (s.d.)38 (8.5) Pre-op Lysholm score* 0-4932 50-6436 65-8313 Mean (s.d.)50 (14.4) Type of defect* Medial femoral61 Lateral femoral13 Trochlear7 Sex Male55 Female26 *stratifying variables Funded by the MRC AUTOLOGOUS CHONDROCYTE TRANSPLANTATION/IMPLANTATION VERSUS EXISTING TREATMENTS ISCRCTN 48911177 NEWSLETTER April 2006 Issue 10 Number of patients randomised PTO>> Baseline information

2. Protocol amendment As most of you already know, the change in patient entry criteria now allows patients to enter the trial 6 months (instead of 12 months) after a previous procedure if the surgeon believes the previous procedure has failed. The protocol has also been altered to clarify that mosaicplasty can be carried out on defects >4cm 2 although smaller defects (1-4cm 2 ) are more readily repairable. Please refer to protocol version 3.2, March 2006 - available from the website: www.active-trial.org.uk Workshops Thanks to Geistlich for supporting the last 3 workshops for ACTIVE surgeons - another is planned for the summer (on either 20 June / 7 July). Thanks also to Dave Adams in the anatomy dept for sorting out the all important stifle joints. Treatment forms The latest version of this form asks The surgeon to confirm whether or not kissing lesions were found. It also has a reminder that the depth of defect should only include bone (if any bone was involved). Forthcoming event The sixth Oswestry Cartilage Symposium is a good opportunity for those involved in ACTIVE to get together. We expect a wide audience but places are limited to 80 delegates. Registration for the meeting will be £100. Some bursaries are available for those people unable to access study leave expenses. ACTIVE staff (coordinators and assessors) can also claim up to £50 for their travelling expenses from the ACTIVE grant. Please contact me a.s.a.p. to register. Can you suggest any other speakers? Sixth Oswestry Cartilage Symposium 9-10 November 2006 RJAH Orthopaedic Hospital, Oswestry All ACTIVE members welcome Speakers as confirmed so far: Matthias Steinwachs (Freiburg, Germany) Clinical results of ACI after serum-free cell cultivation ACI with periosteum vs chondro-gide Anthony Hollander (Bristol) Cartilage resurfacing for advanced OA Sven Kili (Chester) Autologous matrix induced chondrogenesis (AMIC) Roland Jakob (Fribourg, Switzerland) AMIC in OCD and femoropatellar OA Vladimir Bobic (Chester) ACI rehab: Are we too restrictive? Sally Roberts (Oswestry) Histology of chondro-gide Nikki Goodstone (Keele) Biochemical analysis of ACI repair tissue Andrea Bailey (Oswestry) Effects of non-concurrent strength & endurance rehab following ACI in knee Louw van Niekerk (Northallerton) Two-year results after ACI in patients with high physical demands Richard Gray (Birmingham) ACI: why we still don’t know James Richardson (Oswestry) ACTIVE Trial update Other Events Round table discussion for ACTIVE collaborators Patient interview & examination Conference dinner Study day for ACTIVE assessors I’m very aware that we still haven’t had a special study day for ACTIVE assessors. If you are an assessor and would like to attend a study day at Oswestry please let me know and I will arrange a date for this summer. If you think two trips to Oswestry is too much in one year then I urge you to at least attend the conference as there will be much going on of interest to you. I look forward to hearing from you. Best wishes, Heather Heatherj.smith@rjah.nhs.uk