Surgery of the Knee: Cartilage Restoration - Osteochondral Allograft, Microfracture, OATS, and ACI
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The best treatment for a knee injury or disease Is one of biologic origins that restores the knee to a state near normal. ACL (anterior cruciate ligament) reconstruction, anatomic repair of knee fractures, and meniscal repair are three types of biological surgical repairs that are very successful for injured knees.
Orthopedists as well as patients often find managing a full-thickness, symptomatic chondral lesion of the knee to be problematic.
Injury that causes articular cartilage cell death can be treated effectively by restoring the joint's surface cells. The articular cartilage is the shiny white surface that composes all the joints in the body. It is the surface cell layer of the joint.
Four separate treatment options are possible: Osteochondral Allograft, Microfracture, Osteoarticular transfer system (OATS), and Autologous Chondrocyte Implantation (ACI).
Click here for more on Arthroscopy of the Knee.
In a young patient, a small lesion can be treated with Microfracture surgery. In this method, a pick-like tool is used to enter the marrow of the knee under the chondral defect. Multiple entries stimulate the bone marrow, which, in turn creates repair tissue. This tissue fills the chondral defect with fibrous cartilage tissue.
In this scenario, the patient will be on crutches for a month to eight weeks. The patient must not participate in sports for a six months to year. Additionally, the patient must realize that it may take up to eighteen months to be completely pain free.
There is a procedure that can restore the knee surface to almost normal condition. This is called autologous chondrocyte implantation (ACI). This procedure is used in the case of large knee defects.
Articular cartilage cells can be harvested from the healthy part of the injured knee for utilization in ACI. There are very specific criteria that must be met for this surgery to be used.
Here are the surgical indications for ACI. First, the injury must be a full-thickness, symptomatic, weight-bearing chondral injury of the femoral articular surface. Second, the patient must be physiologically young. Third, the patient must agree to cooperate with the rehabilitation process for eighteen months.
There is no guarantee of successful surgery to the tibia and patella. In fact, insurance companies will often refuse to pay for this type of surgery. It is important to note that ACI is not a workable procedure for the treatment of osteoarthritis. In this condition, two reciprocal joint surfaces experience damage. X-rays will reveal narrowing of the joint space. Additionally, bone spurs will be in evidence. 3T MRI (magnetic resonance imaging) may be used to assess for ACI. By using this procedure, the proper treatment can be determined.
Click here for more on Dr. Stefan Tarlow, a leading Phoenix knee surgeon.
Orthopedists as well as patients often find managing a full-thickness, symptomatic chondral lesion of the knee to be problematic.
Injury that causes articular cartilage cell death can be treated effectively by restoring the joint's surface cells. The articular cartilage is the shiny white surface that composes all the joints in the body. It is the surface cell layer of the joint.
Four separate treatment options are possible: Osteochondral Allograft, Microfracture, Osteoarticular transfer system (OATS), and Autologous Chondrocyte Implantation (ACI).
Click here for more on Arthroscopy of the Knee.
In a young patient, a small lesion can be treated with Microfracture surgery. In this method, a pick-like tool is used to enter the marrow of the knee under the chondral defect. Multiple entries stimulate the bone marrow, which, in turn creates repair tissue. This tissue fills the chondral defect with fibrous cartilage tissue.
In this scenario, the patient will be on crutches for a month to eight weeks. The patient must not participate in sports for a six months to year. Additionally, the patient must realize that it may take up to eighteen months to be completely pain free.
There is a procedure that can restore the knee surface to almost normal condition. This is called autologous chondrocyte implantation (ACI). This procedure is used in the case of large knee defects.
Articular cartilage cells can be harvested from the healthy part of the injured knee for utilization in ACI. There are very specific criteria that must be met for this surgery to be used.
Here are the surgical indications for ACI. First, the injury must be a full-thickness, symptomatic, weight-bearing chondral injury of the femoral articular surface. Second, the patient must be physiologically young. Third, the patient must agree to cooperate with the rehabilitation process for eighteen months.
There is no guarantee of successful surgery to the tibia and patella. In fact, insurance companies will often refuse to pay for this type of surgery. It is important to note that ACI is not a workable procedure for the treatment of osteoarthritis. In this condition, two reciprocal joint surfaces experience damage. X-rays will reveal narrowing of the joint space. Additionally, bone spurs will be in evidence. 3T MRI (magnetic resonance imaging) may be used to assess for ACI. By using this procedure, the proper treatment can be determined.
Click here for more on Dr. Stefan Tarlow, a leading Phoenix knee surgeon.
About the Author:
Dr. Tarlow is a Board Certified Orthopaedic Surgeon with more than 20 years experience focusing on knee surgery. After 19 years of practice, he opened his own clinic, Advanced Knee Care, in Phoenix, Arizona. Click here to learn more about Dr. Tarlow, Phoenix knee surgery and ACL Reconstruction in Phoenix, Arizona.
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