Some patients who have articular cartilage defects or cartilage damage may benefit from a treatment known as cartilage restoration. Donor cartilage can come from the patient (autograft transplantation) or from a donor (allograft transplantation). Options include 1) donor cartilage allograft like BioCartilage, 2) autologous (from a patient’s own knee), chondrocyte implantation where cells are harvested, cloned, and then reimplanted, or 3) osteochondral (bone and cartilage) plug implantation called osteochondral autograft (from a patient’s own knee) or allograft (from a donor).
Dr. Lubowitz will perform these procedures using knee arthroscopy, using keyhole size incisions, or sometimes through larger incisions, using an arthroscopically assisted technique.
Options are further explained below:
Osteoarticular Autograft Transplantation
For small articular cartilage defects, your physician may recommend an osteoarticular autograft transplant. During this procedure, he will take one or two small plugs of cartilage and bone from one healthy section of the edge of the knee, and transplant it to the injured area. Using an autograft allows your physician the advantage of having the graft readily accessible without risk of disease transmission. Unfortunately, this particular graft works best for small injuries. A disadvantage of autograft is may be damage which occurs from harvesting the graft from the patient’s own knee.
Osteoarticular Allograft Transplantation
Articular cartilage defects that are larger and more widespread in size may benefit from the use of an allograft transplant. These are articular cartilage grafts that have been harvested from a donor cadaver. Using an allograft allows your physician the ability to fill in defects of unlimited size. A disadvantage of using an allograft for transplantation is the availability, as well as the risk of disease transmission. In addition, because the cartilage contains living cells, patients will be placed on a waiting list that will require them to wait for an appropriate graft to become available. When a graft does become available, the patient must be “on call” and be prepared to have the surgery the following week, (after the graft is tested but urgently while the cells are still healthy).
Articular cartilage defects that are larger and more widespread in size may benefit from the use of an allograft transplant. BioCartilage is articular cartilage allograft that has been harvested from a donor. Using allograft allows your physician the ability to fill in defects of large size. A disadvantage of using allograft is the risk of disease transmission. BioCartilage does not contain living cells, and is readily available for use without a patient having to be “on call”.
Your physician will decide cartilage treatment options are best for individual patients on a case-by-case basic, depending on variables such as the type of injury, the age and activity level of the patient, and other factors.