St. Helena

Cartilage Restoration

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Once upon a time, people with joint pain resulting from cartilage damage just had to grin and bear it. Today, advances in research and technology have made the repair, regeneration and replacement of cartilage possible for athletes and others with debilitating joint cartilage damage — sometimes with such success there is no need to use artificial joints to restore mobility.

For more information or to make an appointment please call us at (707) 967-9011.


The goal of microfracture is to stimulate the growth of new articular cartilage by creating a new blood supply. A sharp tool, called an awl, or a high-speed drill is used to make multiple holes in the joint's surface. The holes are made in the bone beneath the cartilage, called subchondral bone. This action creates a healing response. A new blood supply can reach the joint surface, bringing with it new cells that will form the new cartilage.

Abrasion arthroplasty

Abrasion arthroplasty is similar to drilling. Instead of drills or wires, high-speed burrs are used to remove the damaged cartilage and reach the subchondral bone.

Autologous chondrocyte implantation (ACI)

ACI is a two-step procedure. New cartilage cells are grown and then implanted. First, an arthroscopic surgery is performed and a small amount of healthy cartilage tissue is harvested. The tissue, which contains healthy cartilage cells, or chondrocytes, is then sent to the laboratory.

The cells are cultured and increased in number over a three- to five-week period. A surgical procedure, or arthrotomy, is then performed to implant the newly grown cells.

ACI is most useful for younger patients who have single defects larger than 2 centimeters in diameter. ACI has the advantage of using the patient’s own cells; however, it does have the disadvantage of being a two-stage procedure.

Osteochondral autograft transplantation

In this procedure, cartilage is transferred from one part of the joint to another. Healthy cartilage tissue — a graft — is taken from an area of the bone that does not carry weight (non-weight-bearing). The graft is then matched to the surface area of the defect and impacted into place. This leaves a smooth cartilage surface in the joint.

Osteochondral allograft transplantation

If a cartilage defect is too large for an autograft, an allograft may be considered. An allograft is a tissue graft taken from a deceased donor. Like an autograft, it is a block of cartilage and bone. In the laboratory, it is sterilized, prepared and tested.

These are just a few of many techniques available today. There is vast research being done on new techniques that will continue to change the way we think and treat cartilage injuries. Call (707) 967-9011 to start exploring your options.