What makes me a candidate for this surgery?
You might be a good candidate for this surgery if you have kneecap instability (your kneecap moves out of place), and you have damage to the cartilage in your knee.
Cartilage problems are checked before surgery with an MRI, and again during the arthroscopy at the start of your surgery (a small camera is used to look inside your knee).
What is cartilage, why is it important, and how is it injured?
Cartilage is the smooth, shiny coating at the ends of your bones. It helps your bones glide smoothly when you move your joints. If cartilage is missing or damaged, it can cause pain, extra pressure on the bone underneath, and arthritis.
Cartilage can be hurt by a knee injury (like a patella dislocation) or long-term rubbing from a knee that’s not lined up right.
Unfortunately, your body can’t grow this type of cartilage back on its own.
What does the surgery entail?
First, the surgeon cleans out the damaged cartilage. Then, they repair it using one of the following methods, depending on your age, the size of the damage, and where it is in your knee.
How will my cartilage be repaired?
This depends on many factors including your age as well as the size and location of the cartilage damage. The surgeon will choose from one of the following procedures:
- PJAC (Particulated Juvenile Articular Cartilage) Allograft: The surgeon makes a cut near your kneecap. Damaged cartilage is removed. Small pieces of donor cartilage from a young person are placed into the damaged area. This cartilage can grow into your own cartilage over time. You may need follow-up MRIs to check healing.
- OCA (Osteochondral Allograft): Damaged cartilage and the bone beneath it are removed. A plug of cartilage and bone from a donor is placed into your knee. The plug does not grow, but your body grows into it and accepts it over time.
- MACI (Matrix-Assisted Cartilage Implant): This procedure is done in two stages:
- Stage 1: The surgeon removes damaged cartilage and takes a small sample of your healthy cartilage. It’s sent to a lab to grow into a patch.
- Stage 2: About 4–6 weeks later, the new patch is placed into your knee to fill the damaged area.
How long will I stay in the hospital?
This surgery is typically done as an outpatient surgery, meaning you will go home the same day of surgery.
What are the possible risks and complications of surgery?
While very rare, as with any surgery there is a risk of blood clot, nerve damage, and postoperative infection. With any cartilage restoration procedure there is a risk that the cartilage restoration graft will not take or that it overgrows.
When can I drive
With the left leg, it's ok to drive once you are off opioid medication and you can safely and easily bend your knee to 90 degrees, for the right leg, it depends on when you can safely regain your reaction time in order to keep you and others safe. This is typically around 8-10 weeks postoperatively but depends on your individual surgery and your recovery.
When can I resume jogging?
When you have demonstrated optimal single leg strength, often assessed by the ability to safely perform a controlled single leg step down, and completed a return to run progression under the supervision of your physical therapist and surgeon, you can begin jogging. This often starts with stationary bicycling with transition to elliptical and then treadmill intervals before full return to running.