Cartilage Repair
Cartilage repair surgery aims to create durable cartilage-like tissue around damaged joints where cartilage has deteriorated. Typically, surgical intervention is necessary for cartilage regeneration. Synthetic supplements are often essential for successful cartilage regrowth. Unlike fetuses in the womb, adults lack the innate ability to naturally generate new articular cartilage. This limitation poses a significant challenge for cartilage repair surgeries.
Due to its limited self-repair capability, individuals with joint dysfunction caused by painful cartilage or chondral lesions may require surgery, particularly in joints like the knee, ankle, hip, or elbow. Successful cartilage repair surgery aims to alleviate pain and restore function. Various treatment options exist, and the choice depends on the patient’s specific clinical condition.
What conditions may be treated with cartilage repair?
Cartilage injuries eligible for cartilage repair surgery encompass:
- Articular cartilage defects
- Chondral defects
- Chondral lesions
- Osteochondral defects
- Osteochondritis dissecans lesions
- Osteochondritis dissecans (OCD)
- Avascular necrosis (AVN), also recognized as osteonecrosis
Whole Tissue Options
- Osteochondral Autograft Transplantation Surgery (OATS): Surgeons transplant articular cartilage from a healthy, non-weight bearing area of the patient’s knee to the damaged site, resulting in a durable repair with excellent outcomes, particularly for high-demand individuals. Also known as Autologous Osteochondral Transfer (AOT).
- Osteochondral Allograft Transplantation: Using donor tissue specimens to treat large lesions, especially those involving significant bone segments like osteochondritis dissecans or avascular necrosis. It’s also a salvage procedure for failed cartilage repair surgeries, although long-term durability may be less in high-demand individuals.
- Matrix-Induced Autologous Chondrocyte Implantation (MACI): Surgeons take a sample of healthy cartilage from the knee, isolate and grow the cells in a lab, then seed them onto a collagen patch and implant it into the defect. This patch matures into new, healthy cartilage tissue, particularly effective for femur, patella, and tibia injuries.
- Particulate Juvenile Articular Cartilage Allograft Transplantation: Using small fragments of donor cartilage tissue to promote the formation of cartilage repair tissue. Unlike osteochondral allografts, it lacks associated bone. Surgeons transplant small pieces of donated cartilage into the damaged area, securing them with fibrinous glue. This method has shown clinical efficacy, especially in high-demand individuals.