ACTIVE

Prospective randomised trials are the gold standard for improving treatment. ACTIVE is a large clinical trial in the UK and Norway funded by the NHS and the MRC designed by myself and Karen Ashton in collaboration with the Birmingham Trials Unit. Heather Smith is the coordinator and if you are looking for ACI treatment in the UK then this is one way to ensure funding and at the same time help to prove for the future if ACI could be a benefit over other treatments. Although ACI is more expensive than other treatments, the potential long term benefit is such that it only needs to be 20% better than other treatments to be cost-effective. The difficulty in demonstrating a benefit is that there is such variation in outcome of any treatment and only vague methods of assessment, that it is difficult to identify the effects of different treatments. There is still no proof that ACI is better than say microfracture or mosaicplasty.