Articular cartilage grafting of the knee

Cartilage transplant is a useful technique for restoring injured cartilage in the knee. The Royal National Orthopaedic Hospital has a worldwide reputation for carrying this procedure out and Mr. Miles has performed the procedure several hundred times with high success rates. He is also involved in research into the longterm outcomes of cartilage transplant and into new techniques to treat cartilage injuries. 



Cartilage transplant is a two stage operation. The first stage is an arthroscopy and collection of a small sample of cells to be grown. The second stage is an open procedure with a wound as shown here. At the base of the wound one can see a defect in the (white) cartilage so (pink) bone is visible.

This is a picture taken after implantation of the cartilage cells. This is a very delicate operation as the cells are quite easily damaged. The cells go through a phase of attachment to the underlying bone then bign to produce hyaline cartilage.

 

The rehabilitation phase after surgery is long to protect the cells in the graft. It involves movement to stimulate growth but avoiding too much pressure which can damage the graft. This usually requires crutches for six weeks, depending upon the site of graft within the knee.

 

Return to activites and sports is, again, dependent on the injury. Typical times are:

 

Swimming       3 months

Cycling            4 months

Running           9 months

Ballet             10 months

Cricket            10 months

Football/rugby 12 months