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Benefits of cartilage autografts in knee

A The use of autologous cartilage autografts in the knees has developed over the last 10 years and is established as an acceptable and useful method for selected patients.

It should be emphasised the treatment is for injuries

to the cartilage of the knee in a joint that is otherwise normal and is not yet a treatment for osteoarthritis.

The indications are for a patient aged between 15 and 50 who has a proven articular cartilage defect of the knee associated with pain and disability.

If the patient has other problems in the knee then these need to be considered before carrying out the cartilage cell transplant.

The procedure involves an arthroscopic biopsy of cartilage from the knee which is then grown up in culture for three to five weeks before being re-implanted into the defect of the knee by an open operation. The patient is free to go home after three to four days and can weight-bear – although

only bend the knee after 10 days' immobilisation.

Intensive physiotherapy is required in the first six weeks and patients should not be involved in sport for one year after surgery. In a study of 61 patients followed for five to nine years, 60-80 per cent had good results.

George Bentley is professor of orthopaedic surgery, Royal National Orthopaedic Hospital,

Stanmore, Middlesex

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