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What are the Different Types of Cartilage Repair?

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  • Written By: Debra Durkee
  • Edited By: A. Joseph
  • Last Modified Date: 18 November 2016
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Joint pain can be the result of damaged or deteriorating cartilage, and if diagnosed by a medical professional, there are a number of options for treatment that a person can undergo for cartilage repair. Autologous chondrocyte transplantation (ACI) is a long process that is typically reserved for younger patients, and there is a similar, newer process called cell-based cartilage resurfacing that has been developed to shorten recovery. Microfracture is a procedure that relies on the body's ability to heal itself. Other options requiring surgery, usually for those individuals who show significant cartilage damage, include meniscus transplant; osteochondral allograft; and osteochondral autograft transplantation, or mosaicplasty.

ACI requires weeks to complete. First, cells are removed from a section of cartilage that is non-essential and non-weight bearing, usually a part of the knee. These cells are then grown in a lab for as long as two months before the patient undergoes surgery to replace damaged or deteriorated tissues with the newly grown cells. This procedure is usually done on young patients with a significant cartilage defect of more than .78 inches (2 cm) in diameter. Although the process is long and involves open surgery, there is the benefit that there is no chance of the patient's body rejecting the cells because they are grown from his or her own tissue.

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Cell-based cartilage resurfacing is a cartilage repair option that is similar to ACI because healthy cells are removed from the patient and grown in a laboratory setting before being replaced into the damaged knee. In ACI, however, the cells themselves are replaced and allowed to grow in the knee. The laboratory process of cell-based cartilage resurfacing is different and incorporates the growth of the cartilage itself. Cells develop and reproduce around a reproduction of the environment in which they will be transplanted, and the entire piece of cartilage is placed inside the joint. This reduces healing time because the cartilage is already grown.

Microfracture is an option for cartilage repair that does not involve open surgery. Instead, the cartilage is encouraged to grow on its own by puncturing the surface of the bone to increase blood flow to the area. Cartilage is repaired in the natural growth process. Another arthroscopic option is a meniscus transplant, which is usually done on patients who have suffered damage to the meniscus. The meniscus is a layer of cartilage that acts as a shock absorber, and, with the aid of a small incision, the meniscus of the patient is either replaced by one from the body of an organ donor or the new piece is stitched to the existing piece of meniscus.

For larger and more severe defects, the options for cartilage repair can get more invasive. A mosaicplasty typically involves a large incision to allow for taking healthy cartilage from one area and grafting it to the damaged area. Multiple grafts in the same area create a mosaic-like appearance, hence the name. Alternately, if there is not enough healthy tissue to be transplanted, an osteochondral allograft can be performed. The difference in this procedure is that the grafts are taken from a deceased donor whose tissue is a match for the patient.

Even the smallest lesions on the surface of a piece of cartilage can cause joint pain and a loss of motion. It can be caused by trauma, injury, congenital defects or even repetitive strain on a joint. Cartilage repair is often an option that has a long recovery period associated with it but can be helpful in restoring a person's lifestyle and activity level.

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