Osteochondral Allograft, Microfracture, OATS, and ACI Surgery of the Knee: Cartilage Restoration
Biologic treatments are best for knee disease or injury. Biologic treatment restores the knee to a near-normal state. Meniscal repair, reconstruction of the ACL (anterior cruciate ligament), and anatomic knee fracture repair are 3 of the types of biological surgical repairs that work well for knee injuries.
A symptomatic full-thickness chondral lesion of the knee presents a problematic management issue for patients and orthopedists.
Injury that leads to articular cartilage cell death is well treated by restoration of the surface cells of the joint. The shiny white surface that composes all the joints in the body is the articular cartilage or surface cell layer of the joint.
There are 4 ways to treat damage to this tissue. They are: Autologous Chondrocyte Implantation (ACI), Osteochondral Allograft, Osteoarticular transfer system (OATS), and Microfracture.
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 situation, the patient will use crutches for four to eight weeks. The patient must agree not to participate in sports for 6 to 12 months. Also, the patient must understand and accept that it may be eighteen months before complete freedom of pain can be expected.
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.
These conditions are: 1. A full-thickness, weight-bearing, symptomatic chondral injury of the femoral articular surface. 2. A physiologically young patient. 3. The patient must understand and agree to participating in an 18 month rehabilitation process.
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 Arizona knee surgeon. - 17274
A symptomatic full-thickness chondral lesion of the knee presents a problematic management issue for patients and orthopedists.
Injury that leads to articular cartilage cell death is well treated by restoration of the surface cells of the joint. The shiny white surface that composes all the joints in the body is the articular cartilage or surface cell layer of the joint.
There are 4 ways to treat damage to this tissue. They are: Autologous Chondrocyte Implantation (ACI), Osteochondral Allograft, Osteoarticular transfer system (OATS), and Microfracture.
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 situation, the patient will use crutches for four to eight weeks. The patient must agree not to participate in sports for 6 to 12 months. Also, the patient must understand and accept that it may be eighteen months before complete freedom of pain can be expected.
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.
These conditions are: 1. A full-thickness, weight-bearing, symptomatic chondral injury of the femoral articular surface. 2. A physiologically young patient. 3. The patient must understand and agree to participating in an 18 month rehabilitation process.
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 Arizona knee surgeon. - 17274
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, knee surgeons in Phoenix and ACL Surgery in Phoenix.
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