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| CARTILAGE
TRANSPLANTATION |
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| What
is cartilage transplantation? |
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Individuals who have arthritis have
the surface cartilage of their bone worn away.
The surface cartilage at the end of your bones
in a joint (i.e., shoulder, knee, ankle, elbow)
is smooth and marble-like in appearance. This
marble-like covering allows the joint to move
smoothly and if this covering is lost, bone is
exposed causing pain. This is the definition of
arthritis. |
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Surface
cartilage on the end of the bones that make up a
joint has very little ability to heal. Therefore,
there are procedures designed to transplant cartilage
plus a small piece of bone to areas where the cartilage
is lost. This is called cartilage transplantation.
For small areas, this cartilage can be taken from
an area that is "nonessential" within
the same knee. Oftentimes this cartilage can be
taken from the opposite knee from a nonessential
area. For very large areas where the cartilage is
missing, this cartilage is taken from an allograft.
An allograft is bone and cartilage taken from an
individual who has died. This individual is screened
for all diseases. Once the screening process takes
place, a piece of cartilage and bone is taken from
the "allograft" and transplanted into
the patient. Currently at the University of South
Alabama we have performed close to one hundred twenty
(120) cartilage transplantations. Our ongoing database
registry has indicated significant success with
these procedures. |
| Photo:
Harvest Technique |
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Who
is a candidate for cartilage transplantation? |
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Individuals
who are active and/or who have localized areas of
osteoarthritis are candidates for cartilage transplantation.
This means individuals who have well localized areas
within the knee, ankle, elbow or shoulder, rather
than global arthritis. "Global" means
arthritis throughout the joint. Such patients are
better suited for a total joint replacement. To
better understand whether you are a cartilage transplantation
candidate, please contact the USA Joint Restoration
Service or your physician for a referral. |
| Photo:
Final Plugs |
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Types
of cartilage transplantation |
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Photo: Mosaicplasty
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- Autograft refers to a patient's own cartilage
and, as previously mentioned, this cartilage
is taken from the same knee or from the opposite
knee from a nonessential area.
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- Allograft - this is cartilage and bone that
is taken from a person who died and who was
screened for diseases.
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Other
surgical procedures performed alone or in conjunction
with cartilage transplantation |
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| WARNING:
The image above is from an actual surgery.
Click on it to see it. |
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In
addition to cartilage transplantation, certain other
procedures may be performed at the same time. These
procedures include ligamentous reconstruction. If
your anterior cruciate ligament (or posterior cruciate
ligament) is torn at the time of injury, then the
knee will need to be stabilized by reconstructing
these ligaments. These procedures are frequently
done at the same time. In addition, if you are missing
a meniscus, which is the fibrous, or rubbery, type
cartilage between the two bones in your knee joint,
then this cartilage can be transplanted at the same
time that the surface cartilage is transplanted
within your knee. |
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Finally, if you are a candidate
for cartilage transplantation and it is noted
that your cartilage is worn away as a result of
abnormal forces within your knee, another procedure
may also need to be performed. For example, if
you walk bowlegged, the  majority
of weight is being borne on the inside of your
knee. If cartilage transplantation is to take
place, you could wear away that cartilage transplant
by continuing to walk with most of your weight
being put on the inside of the knee. Therefore,
at the time of cartilage transplantation your
doctors may want to "realign" your knee
so that you walk on the center or the outside
of your knee. This unloads the area where the
cartilage transplantation takes place. Such a
procedure is called a high tibial osteotomy
and it is performed by making a small incision
below your knee joint. The bone is cut and a piece
of graft is placed in this area along with a small
plate, to straighten your leg from a bowlegged
to a straight appearance. This procedure is done
less frequently than ligamentous reconstruction
or transplanting a meniscus. However, it is occasionally
required at the same time of cartilage transplantation.
You should contact your physician to see if you
are a candidate for this procedure. |
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USA
Cartilage Transplantation Registry |
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| WARNING:
The image above is from an actual surgery.
Click on it to see it. |
This registry refers to a database, or list, of
patients who have undergone cartilage transplantation
either from their own cartilage or from donor cartilage
(allograft). This information is kept anonymous
at USA, enabling physicians to follow those patients
who have undergone these transplantations and determine
how they are doing. If you are a candidate for cartilage
transplantation and agree to this surgical procedure,
you will complete a questionnaire. This data will
be anonymously entered into a database. Each year
information will be entered from specific questionnaires.
A physical examination will be performed to assess
how you are doing after your cartilage transplantation.
It is critical that the physicians know prior to
transplantation how you are doing so that a comparison
can be made after your surgical procedure. For more
information on cartilage transplantation registry,
please contact Dr. Pearsall's office at
(251)
665-8200. |
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