Cartilage Restoration Procedure
Microfracture Microfracture is a common surgical technique used to repair damaged knee cartilage and is frequently performed on athletes. The surgeon makes a tiny incision on the affected knee and inserts a long thin scope (arthroscope). This scope allows the surgeon to work directly on the joint area. The surgeon uses an ice pick-like tool to drill very small holes (microfractures) into the bone near the defective cartilage. Bone marrow seeps out of the holes, creating a blood clot that releases the cartilage-building cells. Those cells then repair the injured cartilage site.
ACI In an autologous chondrocyte implantation, or ACI procedure, doctors take a few cartilage cells from the knee, grow them in the lab, and re-implant them into the area of cartilage damage. Essentially, it’s a cartilage implant using your own, lab-grown cartilage instead of that of a donor. First, doctors perform an arthroscopic surgery to identify the area of cartilage damage and determine if it is appropriate for an ACI procedure. If so, cartilage cells are collected and sent to a lab where they are grown and multiplied in ideal conditions. Once enough cells have been grown (after about 4-6 weeks), they are sent to the surgeon, and the second surgery is scheduled. During this surgery, a larger incision is used to directly view the area of cartilage damage (not an arthroscopy). A second incision is made over the shinbone and an area of tissue called periosteum is harvested. The periosteum is the thick tissue that covers the shinbone. A patch roughly the size of the cartilage injury area is taken. The patch is then sewn over the area of damaged cartilage, and the lab-grown cartilage cells are injected underneath the patch. Proper physical therapy allows the implanted cartilage cells to continue to grow and repair the injured cartilage area.
OATS In an OATS, or osteochondral autograft transfer system, healthy areas of the body are transplanted into injured area. First, a coring tool is used to make a perfectly round hole in the bone in the area of damaged cartilage. This hole is sized to fit the plug. The next step is to ‘harvest’ the plug of normal cartilage from an uninjured part of the body that won’t miss it. The plug is taken with the underlying bone to fit into the hole that was prepared in the area of damage.
The final step is to implant the harvested plugs into the hole that was created in the damaged area. If the procedure is successful, the implanted bone and cartilage will incorporate into its new environment and repair the injury.