Surgery of the Knee: Cartilage Restoration - Osteochondral Allograft, OATS, Microfracture, and ACI
Treatments of biologic origin are best when treating knee disease or injury. This type of treatment can restore the knee to a near-normal state. Reconstruction of the ACL (anterior cruciate ligament), meniscal repair, and anatomic knee fracture repair are three kinds of biological surgical repairs that have good success with knee injuries.
Orthopedists as well as patients often find managing a full-thickness, symptomatic chondral lesion of the knee to be problematic.
Injury leading to articular cartilage cell death can best be treated by restoring the surface cells of the joint. The surface cells are the articular cartilage. This is the shiny white surface of which all joints in the body are made.
This kind of tissue damage can be treated in four ways: Osteochondral Allograft, Autologous Chondrocyte Implantation (ACI), Osteoarticular transfer system (OATS), and Microfracture.
Click here for more on Arthroscopy of the Knee.
If the patient is young, a small lesion can be repaired with Microfracture surgery. When using this method, a pick-like tool will be used to enter the marrow of the knee multiple times under the chondral defect. These entries will stimulate the bone marrow. This causes repair tissue to be created. The repair 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.
It is possible to restore the knee surface to a near-normal condition with a procedure called autologous chondrocyte implantation (ACI). This procedure is used if the knee defect is large.
ACI uses articular cartilage cells that have been harvested from the healthy part of the injured knee. There are strict indications and use criteria in place where cartilage restoration procedures are concerned.
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.
Surgery to the tibia and patella may not be successful. For this reason, insurance companies often refuse payment for surgery of this type. ACI is not a workable procedure for treating osteoarthritis. This is a condition in which two reciprocal joint surfaces are damaged. X-rays show narrowing of the joint space, as well as bone spurs. The use of a 3T MRI (magnetic resonance imaging) can assess for ACI. This procedure can help determine the proper treatment.
Click here for more on Dr. Stefan Tarlow, a leading Phoenix knee surgeon. - 17273
Orthopedists as well as patients often find managing a full-thickness, symptomatic chondral lesion of the knee to be problematic.
Injury leading to articular cartilage cell death can best be treated by restoring the surface cells of the joint. The surface cells are the articular cartilage. This is the shiny white surface of which all joints in the body are made.
This kind of tissue damage can be treated in four ways: Osteochondral Allograft, Autologous Chondrocyte Implantation (ACI), Osteoarticular transfer system (OATS), and Microfracture.
Click here for more on Arthroscopy of the Knee.
If the patient is young, a small lesion can be repaired with Microfracture surgery. When using this method, a pick-like tool will be used to enter the marrow of the knee multiple times under the chondral defect. These entries will stimulate the bone marrow. This causes repair tissue to be created. The repair 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.
It is possible to restore the knee surface to a near-normal condition with a procedure called autologous chondrocyte implantation (ACI). This procedure is used if the knee defect is large.
ACI uses articular cartilage cells that have been harvested from the healthy part of the injured knee. There are strict indications and use criteria in place where cartilage restoration procedures are concerned.
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.
Surgery to the tibia and patella may not be successful. For this reason, insurance companies often refuse payment for surgery of this type. ACI is not a workable procedure for treating osteoarthritis. This is a condition in which two reciprocal joint surfaces are damaged. X-rays show narrowing of the joint space, as well as bone spurs. The use of a 3T MRI (magnetic resonance imaging) can assess for ACI. This procedure can help determine the proper treatment.
Click here for more on Dr. Stefan Tarlow, a leading Phoenix knee surgeon. - 17273
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 surgery in Phoenix and ACL Reconstruction in Arizona.
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