Thursday, December 22, 2011

Arthroscopic Knee Surgery Options for a Cartilage Defect

By David Greene


If you have a knee cartilage defect entering your 20s 30s or 40s the pain may be debilitating above your every day. It may have been a sports injury or car accident or really anything traumatic they could've led to the cartilage defect that is now causing your knee pain.

Let's use an example and say that you are a competitive basketball player. You play at a professional level, and in a game you unfortunately twist you knee and your ACL tears. As you are falling over from the injury, you end up with a cartilage defect along with a medial meniscal tear. What would be an result of all the trauma be?

To begin with in this modern era ACL reconstruction has become very effective and sophisticated. Your ACL itself would become extremely functional again after surgery and your new ligament may be from your own tissue or with a cadaver graft. In addition, if the medial meniscal tear is not too large a surgical shaving could get rid of the pain and leave enough of the cartilage to absorb shock with movement. The end result though maybe a step in amount of pain from the cartilage defect that is a deep knee pain and may shorten your athletic career and lead to a life of pain.

One surgery type that works pretty well for a cartilage defect is called a microfracture. It is an arthroscopic outpatient need treatment that involves drilling the defect area several times to start bleeding. This bleeding can spark up some healing and grow some new cartilage in the defect. The bad news is that the cartilage is actually not equivalent to the native cartilage and is a different type of collagen. Fibrocartilage is the name for it and it does not work well as a permanent pain relief option it may work well for a few years but oftentimes the painful start to come back as this fibrocartilage breaks down.

The 2nd treatment that actually helps provide significant pain relief with a cartilage defect is an articular chondrocyte implantation. This procedure, called ACI for short, involves taking some of your native cartilage cells and then having them cultured in a laboratory for a few weeks. Once a decent amount of new cartilage cells have been cultured, they are then shipped back to your surgeon to be implanted in the cartilage defect and a patch of some sort is put on top of it to keep them in place. The procedure often works really well but it does involve 2 surgeries and a significant amount of downtime.

The third procedure that works really well for a cartilage defect is called an OATS procedure which is an Osteochondral Autograft Transfer Surgery. Essentially what this involves is taking cartilage away from the part of the knee that is not a weight-bearing area and shifting over to the area where the defect is that is painful. It is done in multiple punctures that are circular and then essentially placed in mosaic type pattern in the hope that they will grow together with subsequent pain relief.

All of these procedures are done as an outpatient and have decent track record results for knee pain relief. They may reduce the need for treatment with an Arizona pain doctors.




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