Knee Joint Cartilage Defects: Small Cartilage Defect Treatment

Knee Joint Cartilage Defects: Small Cartilage Defect Treatment

This cadaveric surgical video demonstrates a cartilage transplantation procedure used to treat a small cartilage defect in the knee. In this procedure, small pieces of cartilage are transferred from a healthy non-weight bearing area of the patient’s knee to the area of the cartilage defect. This procedure can also be performed with cartilage taken from a donor, which will be shown later.

Here, we see an inside view of a left knee from an arthroscopic camera, with a visible cartilage defect and exposed underlying bone. This cartilage defect is located at the inner end of the femur, or thigh bone. The surgeon begins by using a tiny drill to create small holes in the exposed bone. This helps stimulate the underlying bone marrow to help with healing.

Next, the surgeon inserts a shaver into the knee to shave off pieces of cartilage from a non-weight-bearing part of the knee. The shaver is connected to a suction system and collecting chamber that will gather the removed cartilage. Once enough cartilage is removed, the surgeon disconnects the shaver from the suction and collecting chamber and pulls the plunger out of the collecting chamber to remove the collected cartilage.

Here, we see the cartilage that was removed from the knee. The surgeon then mixes the cartilage with the patient’s own blood or blood components to make a paste-like mixture and places the mixture in a syringe. The surgeon uses a swab to dry off the cartilage defect and exposed bone inside the knee. The cartilage mixture is inserted into the knee and used to fill in the area of missing cartilage.

A sealant will then be placed on top of the new cartilage to hold it in place until it heals. If the surgeon chooses to use cartilage from a donor instead, the cartilage will already be obtained and then prepared in a similar fashion, as seen here. The surgeon will insert the tube into the knee and squeeze out the graft material on top of the prepared bone, followed by placing a sealant on top.

Any small incisions that were made to insert the camera and surgical instruments will be closed with sutures, and the procedure is complete.