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Cartilage Restoration: Knee

What is Cartilage Transplantation?

Cartilage transplantation is a procedure to restore articular cartilage in a joint by transplanting it from another region of your body or using cartilage from a donor.

What is Articular Cartilage?

Articular cartilage is the white tissue lining the ends of bones that form joints. It acts as cushioning material and helps in the smooth gliding of bones during movement.

How is Articular Cartilage Lost?

An injury to the joint may damage articular cartilage, which cannot repair on its own. Cartilage can be damaged with increasing age, normal wear and tear, overuse or trauma. Damaged cartilage cannot cushion the joints during movement and the bones may rub against each other causing severe pain and inflammation.

Indications for Cartilage Transplantation

Cartilage transplantation is indicated for cases of mild-to-moderate cartilage loss where joint replacement is not recommended. Ideally, you should be

  • Under the age of 45
  • Should not be obese
  • Should not have conditions such as rheumatoid arthritis or severe osteoarthritis that complicate joint health nor have bone-on-bone changes that may otherwise be more appropriately treated with knee replacement surgery

Dr. Cole’s related publications

Dr. Cole’s related videos

Specific Procedures

Microfracture/BioCartilage/AutoCart Minced Cartilage

Microfracture is a surgical technique used to repair damaged articular cartilage. An awl or drill is used to create small holes in the joint surface, releasing bone marrow elements that stimulate the growth of fibrocartilage. Microfracture may be augmented with BioCartilage (dehydrated, micronized allogenic cartilage) and/or AutoCart Minced Cartilage (autologous cartilage). BioCartilage consists of dehydrated cartilage, which is combined with either bone marrow concentrate, platelet-rich plasma, and/or autologous cartilage harvest (AutoCart). This mixture can be used as an allograft equivalent to treat localized cartilage defects. Before BioCartilage placement, the defect is smoothed and microfractured to introduce blood supply and stimulate new cartilage to grow. The BioCartilage is placed over the microfractured defect, smoothed into place, and covered with a sealant.

Dr. Cole’s related publications

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Post operative care

Rehab Protocols

DenovNT

DeNovo NT is a minced juvenile articular cartilage allograft. It is used as a cell-based cartilage restoration procedure to treat full-thickness cartilage lesions in a single surgery. The DeNovo graft consists of pieces of viable donor cartilage in a storage media. Similar to MACI, the damaged cartilage area is prepared and sized. The graft is then prepared with a fibrin sealant and placed on the defect. The sealant precludes the need of a collagen membrane.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Matrix Associated Cartilage Implantation

Cartilage is harvested from the joint and cultured in a laboratory. A second surgery is performed to implant the cartilage tissue into the joint. This procedure is indicated for medium-to-large areas of cartilage deficiency.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Osteochondral autograft transplantation

Cartilage with underlying bone is transplanted from a stress-free region of the joint to the deficient (load-bearing) area. This procedure is indicated for small areas of cartilage deficiency.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Osteochondral allograft transplantation

Donor cartilage is shaped and fit into a cartilage-deficient area, creating a smooth surface. This procedure is indicated for medium-to-large areas of cartilage deficiency.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Subchondroplasty/Bioplasty

Subchondroplasty/Bioplasty are surgical procedures used to treat bone marrow edema/lesions. A drill is used to create tunnels in the affected bone, and synthetic bone substitute or bone marrow concentrate with an inductive/conductive bone matrix is used to fill the tunnel.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Meniscus allograft transplantation

This procedure is usually performed in the knee for areas of meniscal deficiency. A donated meniscus is size-matched and sewn into place. Meniscal transplantation is usually indicated where there is pain following previous meniscus removal.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Osteotomy of the femur and tibia

An osteotomy is a surgical bony procedure. It can be used to treat knee malalignment or to offload joint pressure after cartilage transplantation. The bone is cut and adjusted to a more favorable position, and a bony substitute or bone allograft may be used to fill the area of the bone cut and a plate and screws are used to fix the area.

Dr. Cole’s related publications

Dr. Cole’s related videos

Post operative care

Rehab protocol

Cartilage Restoration: Shoulder

What is Cartilage Transplantation?

Cartilage transplantation is a procedure to restore articular cartilage in a joint by transplanting it from another region of your body or using cartilage from a donor.

What is Articular Cartilage?

Articular cartilage is the white tissue lining the ends of bones that form joints. It acts as cushioning material and helps in the smooth gliding of bones during movement.

How is Articular Cartilage Lost?

An injury to the joint may damage articular cartilage, which cannot repair on its own. Cartilage can be damaged with increasing age, normal wear and tear, overuse or trauma. Damaged cartilage cannot cushion the joints during movement and the bones may rub against each other causing severe pain and inflammation.

Indications for Cartilage Transplantation

Cartilage transplantation is indicated for cases of mild-to-moderate cartilage loss where joint replacement is not recommended. Ideally, you should be

  • Under the age of 45
  • Should not be obese
  • Should not have conditions such as rheumatoid arthritis or severe osteoarthritis with bone-on bone changes that would otherwise be a candidate for joint replacement

Dr. Cole’s related publications

Dr. Cole’s related videos

Specific Procedures

Microfracture

Microfracture is a surgical technique used to repair damaged articular cartilage. An awl or drill is used to create small holes in the joint surface, releasing bone marrow elements that stimulate the growth of fibrocartilage.

Dr. Cole’s related publications

Dr. Cole’s related videos

Capsular release and manipulation

Capsular release and manipulation are surgical procedures used to treat pain loss of motion in the shoulder, which can be caused by adhesive capsulitis (“frozen shoulder”) or glenohumeral osteoarthritis. These procedures are done arthroscopically, and the shoulder capsule is debrided to increase range of motion. Post-operatively, patients begin physical therapy nearly immediately.

Post operative care

Rehab protocol

Dr. Cole’s related publications

Osteochondral allograft transplantation

Osteochondral allograft transplantation is a surgical procedure used to treat articular cartilage defects. A donor graft (allograft) is size-matched to the patient, and the donor tissue is implanted into the cartilage defect.

Dr. Cole’s related publications

Post operative care