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Cartilage Replacement Surgery

Using Osteochondral Allograft Transplantation Surgery

Normal joint function relies on an undamaged layer of healthy cartilage on the bony joint surfaces to reduce friction and enable the joint to move smoothly. Sometimes, though, the cartilage can become damaged, either through degenerative conditions like arthritis or from traumatic injuries. Holes, worn spots, and other damage to the joint cartilage (or articular cartilage) are primary causes of joint pain. And unless those issues are managed – quickly and effectively – the damage and resulting symptoms of pain, stiffness and decreased range of motion will become worse and worse.

Cartilage is an "avascular" tissue, which means it contains no blood vessels. As a result, it can take a long time for cartilage to heal. And when continued demands are placed on the joint, the healing process can be delayed further. Plus, cartilage doesn’t contain nerves, which means damage can be progressing long before you begin to notice symptoms. Once pain and other symptoms occur, the damage can be severe.

Traditionally, cartilage damage treatment has been focused on use of medications and injections to reduce symptoms and, hopefully, slow progression of the disease. But more recently, innovative approaches like osteochondral allograft transplantation surgery have begun to revolutionize the way cartilage injuries are treated, relieving symptoms and promoting healing while also delaying the need for joint replacement surgery.

How does it work? Osteochondral allograft transplantation surgery, or OATS, uses cartilage grafts from donors to repair and replace cartilage damaged by degenerative and traumatic injuries. When performed by a skilled and experienced orthopedic surgeon, OATS can help patients return to normal activities without pain, stiffness or other symptoms by restoring the cartilage layer that helps maintain normal joint function.

What happens during an OATS procedure?

The OATS procedure typically is performed on an outpatient basis using general anesthesia. The procedure begins with two incisions at the knee joint. One incision is used for insertion of an arthroscope, a special instrument used for joint surgery. The scope contains a tiny camera that’s used to evaluate the joint and to identify the area of damaged cartilage. The second incision is used to remove the damaged cartilage and to insert the graft or “plug” of healthy cartilage. A small reamer or drill is used to remove the unhealthy cartilage and underlying bone from your joint, creating a cylindrical hole where the plug will be placed. Then the healthy cartilage plug is removed from the same location of the donor tissue to ensure a “match” between the donor site and the recipient site. This match means the donor plug will be a perfect fit for the cylindrical hole made in your joint, and it also ensures the thickness of the cartilage in the “repaired” area will remain consistent. After the donor plug is inserted into your joint, the incisions are closed. More than one plug may be placed in a single procedure.

What is the recovery process like?

The OATS recovery process focuses on a gradual return to normal activities through physical therapy and routine office visits and checkups. Initially, a brace will be used to support the joint and immobilize it during the first week or more while initial healing occurs. During the next few weeks, the brace will be gradually opened to enable greater movement in the joint. Physical therapy during recovery is essential for restoring mobility and strength in the joint as the new cartilage fuses with the surrounding tissue. For most people, it takes about eight weeks or so to return to full weight-bearing activities like walking, and additional time to build up strength for sports and other activities.

Find out more about OATS

OATS is a specialized technique that requires extensive training and expertise in order to achieve optimal results. As a board-certified sports medicine physician and surgeon, Dr. Geoffrey Van Thiel has significant experience in OATS procedures, helping patients throughout the greater Chicago area relieve painful symptoms and get back to the active lifestyles they enjoy. To learn more about OATS and whether it could be a good choice for you, call OrthoIllinois at   and schedule a consultation and evaluation with Dr. Van Thiel today.

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