Cartilage Surgery

Overview:

Articular cartilage is a crucial layer of the knee joint which makes movements at the joint painless and fluid like. The important factor that makes it all the more important is its inability to regenerate and make new cartilage. Like other tissues once the normal architecture is lost, its is replaced by a fibrous or scarred cartilage which does not serve normal purpose. The damage to the cartilage has been divided into stages where 0 stands for least and 4 stands for full thickness cartilage loss. The amount of cartilage loss and the area of loss are important for deciding line of treatment and prognosis of the patient. Selected cases can opt for Cartilage Surgery (OATS/ BMAC and Mosaic-plasty)

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Post OATS surgery plugs inserted

Causes:

Untreated instability and meniscal tears are major reasons of cartilage damage in young patients. Higher number of subluxation episodes lead to a worse form of cartilage damage. This is treatable but with guarded prognosis. It is highly advisable to undergo a surgical procedure for instability to prevent early and irreversible cartilage damage. We offer latest autologous cartilage grafting techniques (OATS) at Arthrocenter.

Diagnosis:

Cartilage injuries can be easily diagnosed and treated. Better techniques and surgical procedures have been developed to functionally rehabilitate the patients to their normal life. The early diagnosis of cartilage injury and , proceeding with cartilage surgery can save the joint from early arthritis and thus give the sportsman a second chance on the field. Diagnosis is usually done with an MRI or a Ultrasonography in the hands of a specialised MusculoSkeletal Radiologist. A team effort is surely needed to yield best results.

A patient testimonial about cartilage surgery. Hear it from a professional athlete. All patients are not the same and have different results in with surgical and conservative modality. A dedicated rehabilitation is essential for coming back to the field. (https://www.youtube.com/watch?v=ZPJnIM5wW2U)

Few FAQ’s for OATS surgery are as below.

Q) What is OATS surgery?

A) It refers to a Autologous(from self) transfer of cartilage from one place to another.

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OATS Surgery instrumentation (Depuy Mitek)

Q) How does it work ?

A) It basically removes bare bone plugs from weight bearing areas and replaces them with cartilage rich bone plugs from NON-Weight bearing area. This essentially causes no loss of natural tissue from the body and no foreign material is used in the surgery.

Q) What are the advantages of cartilage surgery OATS?

  • A) 1.No foreign material used
  • 2.No implants used
  • 3.Lesser risk of infection and other complications
  • 4.Regain movement
  • 5.Improvement in pain scores post surgery
  • 6.Rejoin sporting activities
  • 7.Regenerates fibrocartilage in scarred areas

Q) Instrumentation used ?

A) Special disposable instrumentation set used for extraction and placement of donor and bare bone plugs. Not done arthroscopic but open procedure.

Q) What are disadvantages?

A) No specifics. Just that one has to be the right candidate. Open surgery and resulting scar mark. May have complications.Your sports medicine expert will guide you through the process and will tell you that if you are the right candidate to benefit form the surgery .

Q) How to get diagnosed?

A) Specific musculo-skeletal imaging by an expert radiologist is essential step to diagnose cartilage injuries. These may employ simple tests as MRI or Ultrasonography but have specific sequences which need study. Cartigram is a new modality , slightly expensive but useful.

Q) How to know that I am the right candidate for this surgery ?

A) All cartilage injuries don’t classify for cartilage plug surgery. The main indications for this are :

  • 1. Focal cartilage loss
  • 2. Full thickness loss
  • 3. Fresh injury (6-12 weeks)
  • 4. Absence of generalised changes (arthritis is contraindication)
  • 5. Young age
  • 6. Focussed dedicated rehabilitation
  • 7. Counselled patient