Evolution of Technology

Osteochondral Allograft or Autograft Transfer System (OATS)

Osteochondral grafting is a common method for treating injuries of the cartilage that expose the underlying bone (called osteochondral defects, or OCD lesions). During this procedure, osteochondral grafts replace both the joint surface, or articular cartilage as well as the underlying bone. These grafts can come from either the patient’s own body (called an autograft), or from a tissue donor (called an allograft). An instrument is used to removed a portion of the damaged area, and then a replacement piece made up of cartilage and bone from another site is inserted, which ultimately heals over time.

Evolution of Procedure

Cartilage Transfer

In children and young adolescents, the majority of OCD lesion can be treated without surgery, especially when the body is still growing. A period of rest and avoiding vigorous activities usually results in notable pain relief and improved swelling. If symptoms don’t improve after a period of rest and activity modification, then surgery may be an option. Other reasons for which surgery may be recommended is if the lesion has separated from the surrounding bone, or if the lesion is large. There are a few different surgical options. These include drilling into the lesion, which creates healthy bleeding and areas for new blood vessels to supply the affected areas, which ultimately encourages healing of the surrounding bone. Some lesions can be held in place with either pins or screws. Lastly, if the defect is severe enough, an option is to replace the damaged area with a new piece of bone and cartilage – also known as a graft.

Evolution of Diagnosis

Osteochondral Dissecans (OCD)

Osteochondritis dissecans (OCD) is a condition that can develop in a joint, most commonly in the knee, ankle, and elbow. It occurs when a small piece of joint surface begins to crack and loosen. This small fragment of joint surface can then separate from the surrounding area. The cause is not entirely known, however it’s thought that it’s likely caused by a disruption of blood supply to the area after repetitive trauma or stresses to the bone over a period of time.

OCD lesions can cause pain and an swelling of the involved joint. Symptoms are often worsened by physical activity. More severe OCD lesions can cause symptoms such as catching and locking of the joint to occur. OCDs are most commonly diagnosed on an x-ray, however sometimes an MRI may be ordered to determine the severity of the defect, which can help determine the appropriate treatment.