Cartilage Restoration Procedures
What are Cartilage Restoration Procedures?
The articular cartilage covering the joint surfaces of the knee is a highly specialised tissue that allows smooth, low-friction movement and distributes load across the joint. Articular cartilage has limited intrinsic healing capacity, and once damaged, defects tend to progress and may lead to early osteoarthritis. In younger patients with focal cartilage defects, restoring the joint surface can significantly improve symptoms and delay or prevent the development of arthritis. Several cartilage restoration techniques are available. The choice depends on the size and location of the defect, the depth of involvement, the condition of the underlying bone, the patient’s age and activity level, and the alignment of the limb.
Osteochondral Autograft Transplantation (OATS)
Osteochondral autograft transplantation (OATS), also known as mosaicplasty when multiple plugs are used, involves transferring cylindrical plugs of healthy articular cartilage and underlying bone from a non-weight-bearing area of the knee to the area of the cartilage defect. The graft restores the damaged area with mature, hyaline articular cartilage – the same tissue that naturally covers the joint surfaces.
OATS is well-suited to focal cartilage defects ranging from approximately 1 to 4 cm², particularly in younger, active patients. Larger defects can be addressed with multiple smaller plugs (mosaicplasty) or osteochondral allograft transplantation using donor tissue.
Who is suitable?
OATS is particularly indicated for:
Dr Stoita will review your symptoms, activity goals, and any existing imaging. A detailed clinical examination is performed to confirm the diagnosis and discuss whether this procedure is the right option for you.
Initial visitX-rays, MRI or other imaging may be used to confirm the diagnosis and assess the extent of the condition. In complex cases, 3D computerised modelling may be used to assist with surgical planning.
Pre-surgeryThe procedure is performed under anaesthesia using the most appropriate surgical technique for your condition. Dr Stoita uses minimally invasive approaches where possible to reduce recovery time and optimise outcomes.
Day of procedureProtected weight bearing is required for approximately 6 weeks to allow the bone block to incorporate. Early range of motion is encouraged, typically with a continuous passive motion machine or a structured range of motion program.
Return to running is generally permitted from 3–4 months, depending on progress and the size and location of the defect.
Return to pivoting sport is expected from 6–9 months depending on the size and location of the defect and quality of rehabilitation.
Frequently Asked Questions (FAQ)
In a total knee replacement, the entire knee joint surface is replaced – the ends of the femur (thigh bone), tibia (shin bone), and usually the underside of the kneecap are all resurfaced with artificial components. In a partial knee replacement (PKR), also called unicompartmental knee replacement, only the damaged compartment of the knee is replaced, leaving healthy bone, cartilage, and ligaments intact.
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Although knee arthritis can affect anyone, there are several factors that can increase the risk of arthritis:
- Genetic predisposition
- Previous knee injury or surgery
- Other joint conditions such as rheumatoid arthritis or gout
- Occupations involving heavy manual work
- Age (over 40)
- Female gender
- Being overweight or obese
- Participation in high impact activities or sports (e.g. running, soccer or rugby)
Knee arthritis typically develops as a result of progressive cartilage wear within the joint. This process may occur naturally with age or be accelerated by factors such as previous injury, altered joint alignment, or increased mechanical load.
In some cases, inflammatory conditions such as rheumatoid arthritis can also contribute to joint degeneration.
