I broke my ankle about a year ago. The fracture healed but the painful symptoms never went away. Eventually, they discovered a big hole in the cartilage around one of the ankle bones. The surgeon is going to take a plug of cartilage and bone from inside my knee and put it in the hole in my ankle bone. Have you ever heard of this technique? Is it safe?
When joint cartilage is damaged and needs repair, surgeons can take a plug of cartilage and subchondral bone from a healthy joint and transfer it to the defect. A special tool called the Osteochondral Autograft Transfer System (OATS) is used to harvest the bone-cartilage plug. The graft is called autologous because it is taken from the patient. This technique has been used for several different sites such as the shoulder, elbow, and knee.
Results are fairly good. Younger patients seem to have better outcomes than older adults. There's been some concern about the donor site and problems that might develop there later. It seems the hole left by removing a plug of bone and cartilage doesn't fill back in with strong cartilage. Instead, the donor site is replenished with more of a fibrous tissue. This could leave the donor site at risk for future problems.
Some research has been done in this area. Surgeons have followed selected groups of patients for two to five years keeping track of pain, stiffness, and loss of function of the donor joint (usually the knee). Evidently, obesity is a negative risk factor for less than satisfactory results. The more overweight the person is, the worse their function afterwards. Pain, stiffness, and changes in gait (walking) patterns can occur.
But if you are a young, healthy adult, all should go well. The procedure is both safe and effective in restoring the damaged area with minimal effects on the donor site for most people.
J. Paul, MD, et al. Donor-Site Morbidity After Osteochondral Autologous Transplantation for Lesions of the Talus. In The Journal of Bone and Joint Surgery. July 2009. Vol. 91-A. No. 9. Pp. 1683-1688.
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