Knee Cartilage Surgery

What is knee cartilage surgery?

Although minor damage to the cartilage may heal by itself, more severe injuries usually need surgical treatment. This is normally carried out using keyhole surgery as a day case under a light general anaesthetic. In more complex cases, other procedures may be advised as well. These include knee realignment surgery (osteotomy).

When there is severe arthritis in the knee and joint preservation surgery isn’t possible, Adrian is able to offer partial and total knee replacement surgery. Adipose tissue therapy is sometimes recommended alongside other types of surgery.

Knee chondroplasty (cartilage “tidy up”)

Used for minor cartilage problems, chondroplasty involves removing loose flaps of cartilage (which can cause a sensation of catching or pain in the joint) or fragments of tissue, as well as smoothing damaged areas. It’s usually carried out using keyhole surgery as an outpatient procedure. Recovery is faster than for traditional open surgery and, in most cases, patients can drive again one to three weeks after the operation.

Microfracture

Microfracture can be used to treat more serious knee cartilage injuries and helps with the formation of new joint surface cartilage. The damaged area is tidied up (debrided) and the bone is then punctured with a specially designed tool to create a number of holes that causes the bone to bleed. This in turn causes the cartilage to heal, while forming new tissue.

In order for this type of surgery to be successful, you’ll be advised to use crutches for six weeks after surgery before gradually returning to your usual activities (including sport).

How long does it take to recover?

After your operation, your foot will be placed in plaster, and you will be given crutches to aid mobility. Typically, patients can return home on the same day as their surgery. However, for the first two weeks following the procedure, it’s essential that you do not put any weight through your leg.

After this initial two-week period, your cast will be removed, and you will be given a supportive boot to wear for the next six to eight weeks. During this time, you’ll begin rehabilitation with a physiotherapist, who will provide guidance on exercises and activities to help you regain strength and mobility in the affected area.

Driving is usually possible within three months, or earlier if your surgery was on your left foot, and you have an automatic car. You’ll also be able to resume your usual fitness routine, while continuing with your rehabilitation program as advised by your physiotherapist.

If your job is primarily sedentary, you can expect to return to work within a month. However, if your role is more manual, you may need up to four months to recover fully before returning to work. Regardless of your job type, it’s important to follow your consultant’s advice regarding activity levels and returning to work to ensure a safe and successful recovery.

AMIC: nanofracture

Autologous matrix-induced chondrogenesis, or AMIC® is a new one-stage treatment used to repair cartilage. It combines microfracture surgery with the use of collagen to help repair damage and regain full mobility of the joint.

Carried out using keyhole surgery, it involves a tiny amount of cartilage being taken from your knee and then implanted into a matrix made of collagen which is immediately replaced into the knee joint. Afterwards, you’ll be given a personalised physiotherapy rehabilitation programme to ensure the fastest recovery and best possible results.

In order for this type of surgery to be successful, you’ll be advised to use crutches for six weeks after surgery before gradually returning to your usual activities (including sport).

Knee cartilage transplantation (maci)

This two-stage technique, known as matrix-induced autologous chondrocyte implantation (MACI) is carried out using keyhole surgery. During the first procedure, a tiny amount of cartilage is taken from your knee and then grown in a laboratory to produce more cartilage that is attached to a matrix made of collagen. During the second procedure, the cartilage cells are implanted in the joint. Afterwards, you’ll be given a personalised physiotherapy rehabilitation programme to ensure the fastest recovery and best possible results.

In order for this type of surgery to be successful, you’ll be advised to use crutches for six weeks after surgery before gradually returning to your usual activities (including sport).

OATS surgery

Osteoarticular transfer system, or OATS, usually involves keyhole surgery and possibly a small open incision during which cartilage is removed and replaced with healthy cartilage taken from another area of the joint (autograft transplantation). It can be performed alongside other procedures including ACL surgery. Afterwards, you’ll be given a personalised rehabilitation programme to ensure the fastest recovery and best possible results.

In order for this type of surgery to be successful, you’ll be advised to use crutches for six weeks after surgery before gradually returning to your usual activities (including sport).

Osteochondral allograft transplantation

Healthy tissue from a donor is transplanted to the injured site. This can be performed alongside other procedures including ACL surgery. Afterwards, you’ll be given a personalised rehabilitation programme to ensure the fastest recovery and best possible results.

In order for this type of surgery to be successful, you’ll be advised to use crutches for around six weeks after surgery before gradually returning to your usual activities (including sport).

Dr. Prasad Bhagunde

MS Ortho D Ortho DNB

Senior Orthopaedic Consultant and Sports Medicine Surgeon