In addition to the treatment of osteochondritis dissecans, the Penn Cartilage Center also offers treatment for severe cartilage problems with procedures including:
Autologous Chondrocyte Implantation (ACI)
ACI is most effective in younger patients who have single defects larger than 2 cm in diameter. This two-step procedure involves new cartilage cells being grown and then implanted in the cartilage defect. Healthy cartilage tissue is removed from a non-weight bearing area of the bone. The cells from the tissue are then cultured and increased over the next month.
An arthrotomy is then performed to implant the newly grown cells and a collagen cover or a layer of bone-lining tissue, called periosteum, is sewn over the cartilage defect.
Osteochondral Autograft Transfer (OAT)
An osteochondral autograft transplantation, used for smaller cartilage defects, is when cartilage - a graft - from one part of the joint is transferred to another. The healthy cartilage is taken from an area of the bone that is non-weight bearing. The graft is then matched to the surface area of the defect and impacted in place, leaving a smooth surface in the joint.
Osteochondral Allograft Transplantation
A good candidate for an osteochondral allograft transplantation is a younger, more active individual with a symptomatic, disabling cartilage injury or disease present in the knee, ankle or other joints, such as the shoulder. An allograft is a tissue graft taken from a cadaver donor. Similar to, but larger than, an autograft, it is a block of cartilage and bone that can be shaped to fit the exact contour of the defect and then press fit into place.
Allografts are usually done through an open incision.
The goal of microfracture is to stimulate the growth of new articular cartilage by creating a new blood supply. This is achieved by making multiple holes in the joint surface to stimulate a healing response. Marrow elements reach the joint surface and bring new cells that form the new cartilage.
The best candidates are young patients with single lesions and healthy subchondral bone. This procedure can be done arthroscopically.
A meniscal transplant replaces the damaged meniscus with a new meniscus from a cadaver donor. The new meniscus provides support and acts as a shock absorber. This procedure, which can help knee pain and possibly prevent arthritis, is only performed in cases when most of the meniscus cartilage must be removed.