Cartilage Repair and Transplantation (ACI/OATS)
Cartilage is the tissue that covers the ends of most bones in our body and protects them during movement by allowing the bones & joint surfaces to glide smoothly against each other with less friction.Since articular cartilage does not have a direct blood supply to it ,hence its capacity to repair itself is less.That means cartilage does not heal on its tear leading to degeneration of the articular surface and can develop osteoarthritis later in life.
People of all age groups can be affected by articular cartilage damage. The damage can happen due to any of the following reasons:
Treatment options for cartilage defects
The treatment of chondral damage or cartilage defect in the joint typically depends on certain factors such as the specific site of the defect, size of the defect, severity of patient symptoms, and coexisting ailment within the joint.
In patients with mild symptoms, non-operative treatment or conservative treatment may be beneficial.On the other hand, if an MRI scan shows softening of the cartilage surface with large defects in the joint, in such cases,cartilage replacement is done.
If articular cartilage defects with severe symptoms are left untreated, they can eventually impact one’s ability to move pain free, therefore, causing irreversible joint damage.
Cartilage replacement
is a surgical intervention done to replace the damaged cartilage with the healthy cartilage to recover from injury.It is performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. It helps relieve pain, restore normal function, and can slow down or prevent the development of arthritis.The cartilage replacement procedure is done with a purpose to stimulate the growth of new hyaline cartilage that resembles the original one to facilitate the healing.
Orthopedic Surgeon
is a highly skilled surgeon who performs the most advanced surgical techniques for cartilage repair. He strives to provide his patients with the best clinical outcome possible. The type of procedure is chosen considering the location and overall size of the defect.
Arthroscopic procedures included in cartilage replacement are:
- Microfracture
- Drilling
- Abrasion Arthroplasty
- Autologous chondrocyte implantation (ACI)
- Osteochondral Autograft Transplantatio
Cartilage replacement
is a surgical intervention done to replace the damaged cartilage with the healthy cartilage to recover from injury.It is performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. It helps relieve pain, restore normal function, and can slow down or prevent the development of arthritis.The cartilage replacement procedure is done with a purpose to stimulate the growth of new hyaline cartilage that resembles the original one to facilitate the healing.
Cartilage replacement
is a surgical intervention done to replace the damaged cartilage with the healthy cartilage to recover from injury.It is performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. It helps relieve pain, restore normal function, and can slow down or prevent the development of arthritis.The cartilage replacement procedure is done with a purpose to stimulate the growth of new hyaline cartilage that resembles the original one to facilitate the healing.
Autologous Chondrocyte Implantation (ACI)
ACI is a relatively new and state of the art procedure, approved by “ the Food and Drug Administration“, used to treat isolated full-thickness articular cartilage defects of the joint. ACI is performed for defects of the patella ,and other joints too including shoulder, wrist, ankle. This procedure is carried out in two stages.The first surgical procedure consists of an arthroscopic evaluation of the joint and biopsy of cartilage. where biopsy from articular cartilage is sent to a laboratory to process & grow the chondrocytes (cartilage cells) in large volumes. After a growth period of around 1 month, the second surgical procedure is performed .This is an open procedure during which the cultured cells are re-implanted into the damaged areas of the joint to enhance healing process.
OATS (Osteochondral Allograft Transfer)
The OATS procedure usually begins with an arthroscopic examination, based on which the Orthopedic surgeon decides to perform the procedure.
It is a cartilage transfer procedure where the Surgeon performs the activity of Moving Healthy Cartilage from one Area of the joint i.e. called as PLUGS to the INJURED Area of the Joint. In the OATS procedure, the surgeon only moves one or two plugs of healthy cartilage to the damaged area of the joint because healthy cartilages are larger.OATS procedure is indicated for younger patients especially under 50 and with minimal cartilage damage.
Recovery after Cartilage Replacement Surgery
Physiotherapy is highly recommended after the surgery to improve the range-of-motion of the joint. A patient is encouraged to use a continuous passive motion (CPM) machine to improve the graft’s success.Orthopedic surgeons typically suggest 6 months to return to light sports activities and 9 to 12 months for full sports activities.