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Knee articular cartilage surgery

A biological approach to knee surgery

When your knee cartilage is functioning as it should, the bones in the joint glide over one another smoothly. If the cartilage gets worn down or is damaged, you might experience pain or loss of proper function in the knee joint.

Using a biological approach to knee cartilage repair can delay the need for a partial or total knee replacement, enabling you to make the most of the joint you were born with. Not every hospital offers these innovative procedures.

From techniques that stimulate the growth of new cartilage to create membranes filled with your own cells, discover how our world-class surgeons could help you get back on your feet.

ACI (Autologous Chondrocyte Implantation)

If the damage is less than 2cm in diameter, ACI may be an option. It involves taking a biopsy of your existing cartilage and growing the cells in a lab and inserting it into a collagen membrane. This membrane is then secured into place during a second procedure.

Osteochondral Autograft Transfer

This procedure takes cartilage from another site within your knee joint (autograft) and secures it to the damaged area.

Osteochondral Allograft Transfer

This procedure uses a graft from a deceased tissue donor (allograft). The graft is sized to fit the (usually larger) damaged area and is secured to the bone.

Stimulating bone marrow (Microfracture)

Microfracture aims to stimulate the growth of cartilage tissue within the knee. Tiny holes are drilled into the bone beneath the damaged cartilage, enabling some of the marrow to enter the cartilage, where it stimulates growth.

Autologous matrix-induced chondrogenesis (AMIC)

Often used with microfracture or microdrilling, AMIC is a natural collagen matrix patch which is used to cover an area where there is full-thickness cartilage surface (typically up to 2x2 cm)

Your cartilage repair questions answered.

What is knee cartilage?

Cartilage is the flexible tissue that covers the ends of your bones, enabling them to move over one another smoothly. There are two types of knee cartilage: Articular (which we will focus on here) and meniscal. For details about meniscal repair surgery, please see our dedicated treatment page.

The cartilage in your knee is what keeps your leg moving smoothly. It can get damaged through a direct impact during sport, through repetitive twisting, jumping or bending, or through wear and tear as you age.

There is also a condition called Osteochondritis Dissecans, which is when a section of bone loses blood flow and breaks off, taking the attached cartilage with it.

While there are non-surgical interventions, including resting the knee, if these aren’t effective, surgery may be the next course of action.

Once your consultant has a better idea of the pain and discomfort you are experiencing, they will be able to recommend an intervention that suits your needs.

During a consultation, your knee will be examined and mobilised so that the consultant can see where the joint is catching or not functioning as it should. You may also be referred for an X-Ray, MRI or ultrasound, so that a clearer image of the knee joint can be obtained.

This depends on the cause and scale of the damage, and your needs as a patient. For example, ACI and allograft procedures are usually recommended for younger or more active patients.

Surgery will be tailored to your specific needs and your surgeon will make sure you’re fully prepared ahead of the procedure. Nothing goes ahead until you are completely comfortable.

Most patients will be asked not to drink or eat anything ahead of their surgery. You might also be asked to stop smoking or not to take certain medications. You will also need to consider how you are planning to get home after surgery, as you won’t be able to drive.

Depending on the type of surgery you are having and your specific needs, you will receive either a general anaesthetic, a local anaesthetic or a spinal anaesthetic.

Your surgeon will advise on whether your surgery can be performed arthroscopically, which means using a keyhole/minimally invasive technique.

If you are having an ACI procedure, then you will have two separate surgeries, one to obtain the biopsy and the second to secure the new membrane in place.

Following surgery, you will return to your comfortable private room to begin your recovery.

Most patients can go home either the same day or the day after surgery. The length of your recovery will depend on the surgery performed but can be anywhere up to a year, and you may be on crutches for the first few days.

You are likely to need to start physiotherapy immediately. Our team of physiotherapists is here to guide you through exercises you can do to enhance your recovery.

Biological surgery is an innovative approach that aims to repair cartilage while preserving the natural knee joint. However, as with any surgery, there can be risks and complications. These can include infection and blood clots, as well as the risks associated with anaesthetic.

It is also possible for a graft to fail, even if it is taken from another area of the knee. In this instance, you may require further surgery. Your consultant will discuss the risks and limitations of knee cartilage repair surgery with you ahead of the procedure.

You may be covered by private medical insurance, or you may wish to consider spreading the cost of your surgery by opting for a monthly payment plan.

We aim to make our costs as transparent as possible, but it’s important to talk everything through in detail with your consultant at the time of your appointment. Some costs may be paid directly to the hospital, while others, such as your consultant fees, may be paid directly to the consultant.

Choose Sulis Hospital for your knee surgery

By choosing Sulis Hospital for your knee surgery, you’ll benefit from the expertise of internationally recognised surgeons and brilliant physiotherapists.

We can support you in moving forward faster, with timely access to MRI, X-Ray and ultrasound scans, plus shorter wait times for surgery. Get in touch today and book your consultation with a knee expert.

Treatment Overview

Combining a calming hospital environment with outstanding patient care so you can recover as quickly as possible.

  • Typical hospital stay Daycase

  • Covered by health insurance? Yes

  • Can I pay privately? Yes

You’re in safe hands at Sulis Hospital.

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