Nearly half of the knee related problems involve damage to cartilage, which is called the articular cartilage. When this cartilage gets damaged, it restricts normal movement of the knee and causes pain. Board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide cartilage repair procedures to patients in Las Vegas, Nevada, and surrounding communities.
Candidacy
Cartilage repair procedures are ideal for candidates with an otherwise healthy knee, but not for knees affected osteoarthritis. People with cartilage injury occurring due to one or more of the following problems may make outstanding candidates for cartilage repair. Some of these issues are:
- Sports injuries or trauma
- Repetitive joint use
- Birth defects affecting the normal joint structure
- Hormonal disorders hindering bone and joint development
Procedures
Autologous Chondrocyte Transplantation (ACI)
This is a two-step procedure, which will require several weeks to complete. In the first step, the surgeon will arthroscopically remove healthy cartilage cells from a non-weight bearing site in the knee. The cells are then growth in a lab for about two months.
An open surgery is then performed to implant the newly produced cells. ACI procedure is usually recommended for younger patients with single defects bigger than 2 cm in diameter. Tissue rejection risks are eliminated in this technique because the patient’s own cells are used.
Microfracture
Microfracture procedure can be performed using the arthroscopic technique. The surgeon will create small holes in the knee bone. The subchondral bone, which is the surface layer of the bone, is hard and does not have a good blood flow. When holes are created, the bone allows for bleeding. The marrow cells in the blood then stimulate cartilage growth and promote formation of fibro-cartilage, which covers the injured site.
Osteochondral Allograft
This procedure may be used if the cartilage damage is major and cannot be treated by an autograft. The surgery will be performed using an open incision. The graft may have to be taken from a cadaver donor. The graft will be completely sterilized and prepared prior to the implantation procedure. The graft must be match with the patient’s anatomy. Thereafter, it will be shaped to fit the precise contour of the patient’s defect.
Osteochondral Autograft Transplantation
In many cases, this procedure will be performed as an open surgery, but sometimes it may also be performed with an arthroscope. The surgery involves transfer of the healthy cartilage tissue, called a graft, from one part of the knee to the damaged site.
The graft is removed as a plug of cartilage and the underlying bone. Single or multiple plugs of cartilage may be transferred in this procedure. Each plug will be a few millimeters in diameter.
Follow-up Care
The patient will have to be crutches for about six to eight weeks following cartilage repair surgery. Full recovery will take a few months. The surgeon will closely monitor how the new cartilage is developing and integrating with the existing cartilage. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada, and nearby areas for cartilage repair.
If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.