Cartilage lesions and arthritis is the bane of the human knee. There are not many good options when it comes to treating these lesions in young patients. Yet they cause pain, catching, and loss of functional activity. As a first-line, a simple chondroplasty (clean up/shave) can help but it does not cure the underlying problem.
Other options include a procedure known as OATS (osteochondral autograft transfer system). This procedure involves taking a dowel of bone and cartilage from a place in the knee where it is not needed and placed into the affected area. It is a good alternative for cartilage lesions that are less than a centimeter.
The OATS procedure can also be done with fresh allograft (donated tissue) bone/cartilage plugs for larger lesions. This procedure is my preferred technique for large lesions that have some bone involvement.
My preferred technique for large lesions with normal bone is Autologous Chondrocyte Implantation (ACI). This involves harvesting a small piece of the patient’s cartilage and sending it to a laboratory in Boston where they will grow cartilage cells. These cells can then be implanted into the patient’s knee where they will grow new cartilage to fill the defect. This procedure has the advantage of repairing the cartilage defect with normal cartilage without having to disrupt any of the patient’s bone.
See the below case presentation for an example of ACI. Click on the link below.
Chris Jones, MD