Arthroscopy
Arthroscopy is a technique in which a small fiber optic camera and instruments are placed into a joint to fully evaluate and treat cartilage injuries, determining the potential need for additional surgery.
Osteochondritis dissecans (OCD) repair and fixation
Repetitive stress and traumatic injuries to cartilage and bone in children and young adults may result in inflammation of the bone with later cartilage breakdown or traumatic separation. When caught early, some may be treated without surgery. Others may require arthroscopy with drilling or internal fixation of the OCD lesion to allow for healing.
Matrix-induced autologous chondrocyte implantation (MACI)
For large cartilage defects, with or without bone involvement, MACI procedure uses state-of-the-art cell culture techniques to take cartilage biopsies, and grows them onto collagen membranes that are later implanted into the knee joint to restore area of cartilage damage.
Osteochondral autograft transplantation (OATS)
When there is a small cartilage defect with involvement of underlying bone, this technique is used to take a core of cartilage and bone from another area of the knee and transplant it into the defect. Usually single plugs are used up to 10mm. Post-op, patients will use a brace, are allowed full range of motion, and begin partial weight-bearing. As X-rays show graft integration, progression of weight-bearing is allowed. This technique is best suited for small and uncontained bone defects, or for patients who need to return to work sooner.
Osteochondral allograft (OCA)
When there is a significant cartilage defect with involvement of underlying bone, this technique is used to take a large piece of cartilage and bone from a cadaver, and transplant it into the defect. Usually single pieces are used, but some defects require multiple plugs, known as “snowman” technique. Post-op, patients will use a brace, are allowed full range of motion, and begin partial weight-bearing. As X-rays show graft integration, progression of weight-bearing is allowed. This technique is best suited for larger or uncontained bone defects, or those with early arthritis.
Ligament-stabilization procedures such as anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial patellofemoral ligament reconstruction (MPFL)
Injuries to the ACL, PCL and MPFL can all result in progressive cartilage damage.
Meniscal surgery
Surgical treatment varies when the meniscus is torn vs. when it is damaged repetitively over time or through a major trauma.
Microfracture
Most useful in the hip, shoulder, knee and ankle for smaller chondral defects
Realignment and revision procedures
Realignment and revision procedures such as tibial tubercle osteotomy, high tibial osteotomy, and distal femoral osteotomy. Some knee injuries require knee realignment and/or revision surgery.