Articular Cartilage Restoration
Innovative treatments in cartilage restoration are giving patients and their doctors new options to repair damaged joints without joint replacement. Articular cartilage restoration is the term used for different surgical procedures performed on the cartilage impacted by movement (articulation), specifically cartilage that sits at the ends of our bones where joints form.
By smoothing or regenerating the cartilage surface, these procedures help provide pain relief and may help to slow the progression of further degeneration. Procedures begin with less invasive cartilage “clean-up” and progress into advanced cartilage transplantation.
Using an arthroscope, the surgeon locates the damaged cartilage and scrapes off the hard bone tissue to stimulate the body's healing response. As the abrasion heals, fibrocartilage (similar to scar tissue) fills in the previously missing cartilage.
An arthroscopic surgery where the surgeon creates small openings in the bone surface behind the damaged cartilage to allow blood to flow into the area and build new fibrocartilage.
Autologous Chondrocyte Implantation (ACI)
During ACI, the surgeon uses arthroscopic tools to remove healthy cartilage cells from the patient's knee, which are sent to a laboratory and placed in a biologic solution that encourages them to multiply. Several weeks later, the surgeon places the newly grown cartilage cells into the patient's knee and covers it with tissue to hold the new cartilage in place until it attaches.
OATS Procedures -- Cartilage Transplantation Osteochondral Autograft and Allograft Transplantation
The surgeon removes small sections of healthy bone and cartilage from a non-weight-bearing area of the knee and places it into the damaged area. A similar technique called osteochondrial allograft uses bone and cartilage from a cadaver.
Synovial fluid replacement
Joints contain a lubricating fluid called synovial fluid that helps protect the joints from impact. When injuries or repetitive use cause synovial fluid to break down, less cushioning occurs. Surgeons can inject hyaluronic acid, one of the components in synovial fluid, into the knee joint to restore proper cushioning.
Recovering from Cartilage Restoration
Recovery time depends on the type of cartilage restoration procedure. Due to smaller incisions, arthroscopic procedures typically heal faster than the open surgery involved in cartilage implants and transplantation. Cartilage is slower to health than other areas of the body and must be protected in the weeks following surgery. Patients should also plan for prescribed physical therapy to regain mobility of the joint as the cartilage heals.
- OATS procedure (by Dr. Warren King, MD, of Palo Alto Medical Foundation)
- When to have joint replacement
- Choosing an orthopedic surgeon