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Loss of knee cartilage is a major contributor to painful dysfunction. Cartilage restoration techniques aim to restore or replace the damaged joint surfaces with the goal of reducing pain, improvement in function, and quality of life.
The goal of cartilage restoration surgery is to restore the properties of the damaged native smooth joint surface. There are a variety of cartilage restoration techniques that may be selected based on individual patient, joint, and limb specific factors. These techniques include osteochondral allograft transplantation, MACI procedure, DeNovo NT, OAT autograft, marrow stimulation and others.
Cartilage restoration is performed in patients with painful swelling and/or mechanical symptoms from symptomatic loss of hyaline cartilage. The majority of patients have had prior injury and/or surgery and have failed conservative measures including physical therapy and injection therapy. In general, cartilage restoration is NOT indicated for “bone on bone” arthritis but is used to treat focal cartilage defect(s) in a joint that has preserved spaces on X-ray.
Cartilage restoration is either an outpatient or short overnight stay procedure that takes several hours to perform. This may be performed with concomitant ligament reconstruction, realignment osteotomy, and/or meniscus transplantation surgery. Patients have an initial period of protection using brace/crutches for approximately 6-8 weeks. Post-operative rehabilitation is performed 2-3x/week for several months. Return to work or sport is INDIVIDUALIZED and is based on minimum time from surgery (~6 months) and, more importantly, functional progression with rehabilitation.
Cartilage Repair, Open Incision Technique (Zimmer® DeNovo® NT Natural Tissue Graft)
Cartilage Repair, Arthroscopically-Assisted Technique (Zimmer® DeNovo® NT Natural Tissue Graft)
MACI® (Autologous Cultured Chondrocytes on a Porcine Collagen Membrane)
Osteoarticular Transfer System (OATS)
Microfracture Drilling Procedure for Isolated Chondral Defect
Return to Sports Following Knee Cartilage Restoration
AOSSM Sports Medicine Fellows Webinar Series: Cartilage Restoration and Osteotomies
The MACI Implant for the Repair of Articular Knee Cartilage
MACI implant multidisciplinary panel
Scaffolds, or Cell-Based, or Allograts?
“I want to give a big shout out to Dr. Seth Sherman. I have my 1-year post-op appointment on October 4th (literally, my 1-year anniversary). Dr. Sherman gave me my life back by performing a very rare knee surgery on me. Without him and his knowledge and wonderful team, I would still be lacking a life without any type of activity.” – WhitneyMore Testimonials
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For knee, shoulder and other sports medicine conditions.