Articular cartilage repair is a surgical procedure aimed at treating damage to the cartilage that lines the ends of bones within a joint. Articular cartilage has a crucial role in providing smooth, low-friction surfaces for joint movement, and damage to this cartilage can lead to pain, inflammation, and reduced joint function. Cartilage repair techniques are designed to stimulate the body’s natural healing response and promote the formation of new cartilage tissue.
Several techniques are used for articular cartilage repair, including:
- Microfracture: This minimally invasive procedure involves creating tiny holes in the bone underlying the damaged cartilage. The holes allow bone marrow cells to enter the area of cartilage injury, where they can form a blood clot that stimulates the growth of new cartilage-like tissue. Microfracture is most effective for treating small cartilage defects in weight-bearing areas of the joint.
- Osteochondral autograft transplantation (OATS): In this procedure, healthy cartilage and underlying bone are harvested from a non-weight-bearing area of the joint and transplanted into the site of cartilage damage. OATS is particularly useful for treating larger cartilage defects or areas where microfracture may not be effective.
- Autologous chondrocyte implantation (ACI): ACI involves harvesting a small sample of healthy cartilage from the patient’s joint, isolating and expanding the chondrocyte cells (the cells responsible for producing cartilage), and then implanting them into the site of cartilage injury. The implanted cells gradually mature and produce new cartilage tissue. ACI is typically used for larger cartilage defects and may require two surgical procedures: one to harvest the cartilage sample and another to implant the expanded chondrocytes.
- Matrix-induced autologous chondrocyte implantation (MACI): Similar to ACI, MACI involves harvesting chondrocyte cells from the patient’s joint and culturing them in a laboratory. However, in MACI, the cells are seeded onto a biocompatible scaffold or matrix, which is then implanted into the cartilage defect. The matrix provides a scaffold for the cells to grow and produce new cartilage tissue.
- Allograft transplantation: In cases where the patient’s own cartilage cannot be used for transplantation, donor cartilage from a cadaveric source may be used to fill the cartilage defect. Allograft transplantation is typically reserved for larger or more complex cartilage defects.
Recovery from articular cartilage repair surgery can vary depending on the specific procedure performed, the size and location of the cartilage defect, and individual factors such as the patient’s age and overall health. Physical therapy and rehabilitation are often recommended to help optimize outcomes and promote healing. It’s essential for patients to follow their surgeon’s postoperative instructions carefully to ensure the best possible outcome.
