Articular Cartilage Surgery Overview
Certain defects can be treated with an arthroscopic procedure called chondroplasty. This involves using a camera and small instruments to trim away the damaged area of cartilage to alleviate the patient’s symptoms and prevent further progression of the defect. This procedure is typically undertaken in patients who do not have full thickness defects (down to bone). In patients who do have a full thickness loss of cartilage, the options include microfracture, osteochaondral autograft transfer (OATs), or osteonchondral allograft transplantation (OATs). Microfracture is a technique where a small pick is used to make holes in the bony surface of the defect. This allows the flow of marrow elements and stem cells which form a clot over the defect and eventually cover the area with a fibrocartilage layer.
The two types of OATs procedures are autograft (taken from the patient) or allograft (taken from a donor). In autograft OATs, small plugs of cartilage and bone are taken from another less important area of the patient’s knee and transferred in to fill the defect. In allograft OATs, the cartilage and bone are taken from a donor and also used to fill the defect. These procedures are done with a combination of arthroscopic and open techniques. Dr. Boykin performs each of these procedures and will discuss with the patent what the most appropriate surgery would be for their specific injury. While a cartilage defect is a serious condition, these procedures have proven results in terms of relieving pain and restoring function to the knee.
Recovery Following Articular Cartilage Surgery
Post-operative management varies depending on the specific type of procedure. For chondroplasty, patients are typically on crutches for a few days and allowed to weight-bear as tolerated with full range of motion. For the other procedures, patients are placed into a brace and weight bearing is protected for 6-8 weeks. Motion may be initially restricted and a continuous passive motion (CPM) machine is also typically used for 6 weeks after surgery. The timing for return to activities is dependent on the patient’s symptoms and the type of procedure that was required.
For additional information on chondral defects or osteoarthritis of the knee, or to schedule an appointment to discuss articular cartilage defect surgery, please contact the office of orthopedic surgeon, Dr. Robert Boykin serving patients in Asheville, Arden, Fletcher and surrounding North Carolina communities.