Kneecap Cartilage Surgery

An interview with Dr. Beth Shubin Stein and Dr. Sabrina Strickland

Beth E. Shubin Stein, MD
Beth E. Shubin Stein, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopedic Surgery, Weill Cornell Medical College

Sabrina M. Strickland, MD
Sabrina M. Strickland, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

Kneecap cartilage surgery, also called patellar cartilage surgery, refers to a range of procedures that are used to reconstruct cartilage in isolated areas of the knee where damage has occurred. Patients who develop these defects may do so as the result of patellar instability, bony mal-alignment, or trauma. This condition, referred to as post-traumatic arthritis, is different from that seen in patients with generalized arthritis throughout the knee.

For patients with damage that is restricted to the cartilage in the patellofemoral joint, newer cell-based techniques allow regrowth of cartilage in the defect, where it was once impossible to do so. Implantation of donor juvenile particulated cartilage (Denovo®) is one commonly used option.  Patients with cartilage damage that also involves the bone may be candidates for Osteochondral Allograft Transplantation Surgery (OATS). To perform this procedure, the orthopedic surgeon removes cylinders of damaged bone from the patient’s kneecap and replaces it with donor bone and cartilage.

Patients undergoing patellofemoral cartilage surgery receive regional anesthesia—an spinal block that numbs the lower half of the body—and sedation. The entire surgery takes about an hour and patients return home the same day.  Recovery after patellar cartilage surgery (or trochlear cartilage surgery) involves wearing a brace locked straight for six weeks. The patient is permitted to weight bear during this time and bend the knee to sit and for some specific exercises. There is a very low rate of complications, which includes stiffness, infection, or blood clots.  Often this surgery is combines with bone realignment surgery or patellar stabilizing surgery.

Isolated areas of patellar cartilage damage can occur in individuals who are still quite young, and patellar cartilage surgery is generally considered for patients ranging from age 12 to 50. In patients over 50, patellofemoral joint replacement maybe a better option.

Summary by Nancy Novick

 

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