Cartilage Restoration
Cartilage Restoration is a procedure where a patient’s knee is resurfaced, realigned and stabilized thereby avoiding a joint replacement.
Cartilage restoration is especially effective in patients who are under 50 and active.
Articular cartilage is a firm, smooth and slippery covering on the ends of bones that protects and cushions the bone joint. Injuries to this cartilage can cause pain and swelling. If partially or fully detached injured cartilage can cause mechanical symptoms such as “locking up or “catching.”
If various non-operative treatments fail, surgery may be required. One of the surgical options is cartilage restoration.
There are two types of cartilage restoration:
ACI (Autologous Chondrocyte Implantation):
ACI is indicated for larger areas of full thickness cartilage loss, and requires two surgeries. First we arthroscopically harvest normal cartilage cells from one area of the knee not needed. The second surgery is an open surgery where we implant the cartilage cells back into knee to repair the damaged area. The cells are either injected under a water tight membrane or on a special patch.
We are currently working on a one step process, where the harvest and the implantation are performed during one surgery.
Osteochondral Transplant:
Cartilage and bone transplants are indicated when the damaged area is very large, if there is failure of one of the other techniques, or if bone is also injured along with the cartilage. This is when cartilage and bone plugs are harvested from either an uninjured non-weight bearing area of the knee, or from a donor (cadaver), and then transplanted to cover the injured area of bone and cartilage.
Cartilage restoration surgery can take 1-4 hours depending on the injury.
Recovery varies but can take 2-3 months before weight-bearing activities can be pursued.