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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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My son is an Olympic hopeful in figure skating. He was out playing hockey with some friends and suffered a deep injury to the knee cartilage. We've taken him to several surgeons who have suggested different ways to repair this problem. They all seem to have their pros and cons. What do you think of the one where they take your own cartilage and use it to patch the hole?

Athletes like your son are often at risk for full-thickness (down to the bone) chondral (cartilage) injuries caused by acute or repetitive trauma. Patients with severe damage to the knee cartilage have several treatment options. Usually surgery is required. Surgical repair procedures include debridement, microfracture, drilling or abrasion, or osteochondral grafting. The one you are thinking of is called autologous chondrocyte implantation (ACI). It was originally designed for patients who had a failed primary (first) procedure. In autologous chondrocyte implantation (ACI), healthy cartilage cells are harvested from the patient and used to grow more healthy cells to fill in the defect. Most of these patients have had prior treatment with one of the other methods to treat damage to the articular (joint) cartilage. Although the procedure was originally intended for patients with no other treatment options, the use of this repair method has expanded. It's still reserved for the repair of lesions on the severe end of the spectrum. It's been around for 20 years now, so we have reports of long-term studies to rely upon to support its safety, effectiveness, and durability. Patients are still handpicked by surgeons for the procedure. It's not just done on anyone. Patients must meet certain criteria. This may differ from surgeon to surgeon. For example, age may be a factor (patient can't be too young or too old). They may not be eligible if they have had a previous ACI treatment on the same knee, removal of the meniscus (meniscectomy), or knee arthritis (osteoarthritis or rheumatoid arthritis). And not all surgeons have the advanced skill and training to perform this particular procedure. When you find the surgeon you are most comfortable with, listen to his or her counsel, ask questions, and then make your decision.


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