Overview
This surgical procedure replaces damaged cartilage in the knee joint with healthy cartilage cells. These cells are harvested from healthy portions of the knee and are grown in a lab for implantation. This procedure is usually performed in two stages, with two separate surgeries.
Preparation
The patient is positioned so that the front of the knee is clearly visible to the physician, and the area is cleaned and sterilized. Local anesthesia is administered to numb the incision site. General anesthesia or sedation is used.
Accessing the Knee
Two to five small incisions are created, and an arthroscopic camera and other tools are inserted. The camera allows the surgeon to view the procedure on a monitor.
Harvesting the Cells
Tools are used to collect healthy cartilage cells from the knee joint. These cells are sent to a laboratory, where they are cultured to grow new cartilage cells. The incisions are closed with sutures or surgical staples, and the knee is bandaged. The new cartilage cells take about four to six weeks to grow. When enough cells have grown, the patient returns to the operating room for a second surgery during which the cells will be implanted.
Preparing to Implant the Cells
The patient is positioned so that the front of the knee is clearly visible to the surgeon, and the area is cleaned and sterilized. General anesthesia is administered.
Harvesting a Patch
An incision is made in the front of the knee, just to the side of the patella, to allow access to the damaged cartilage. A second incision is made over the top of the tibia and a small amount of the tissue that covers the tibial bone, called the periosteum, is harvested.
Applying the Patch
The periosteal patch is sewn over the area of damaged cartilage, creating a secure seal. The healthy, cultured cartilage cells are then injected underneath the patch.
End of Procedure and Aftercare
The incisions are closed with sutures or surgical staples and the knee and leg are bandaged. A hospital stay of one to two days will be necessary, and patients will receive physical therapy. Weight should not be applied to the leg for at least six to eight weeks. Full recovery can take up to 12 months.
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