OATS
Osteochondral (bone and cartilage) autograft transfer system involves the harvesting of healthy cartilage from a non-weightbearing part of the patient’s body and transplanting it into the cartilage defect, typically within the same joint. Osteochondral autograft transfer system or OATS has been shown to be superior to microfracture but requires expert technical skills. OATS provides immediate filling of defects with the transfer of hyaline cartilage harvested from non-weightbearing areas of the joint. OATS is typically used to repair localized cartilage defects to restore the joint’s smooth functioning and to alleviate pain.
Studies report that the OATS procedure is at the forefront of cartilage restoration surgery in the knee, offering superior return to sports rates and restoring long-term function. Traditionally it has been performed as an open surgical procedure with reliable outcomes, today it can be performed as an arthroscopic minimally invasive procedure for defects in the femoral condyle (the thigh bone).
Young and active patients who have persistent symptoms, a single osteochondral defect of the femur (usually < 3-4cm2), have failed previous conservative and have normal ligament stability and an intact meniscus. Contraindications include obesity, active infection, generalized osteoarthritis, and other conditions. A thorough assessment of the patient’s condition is essential. An MRI is imperative to confirm the severity of the defect and identify the size and location of the cartilage defect.
This surgery is usually performed under general anesthesia. It is a stepwise sequence of events to successfully perform an osteochondral autograft.
- The procedure begins with a diagnostic arthroscopy and evaluation of the joint.
- All loose bodies, broken pieces of cartilage floating in the joint, are removed.
- The defect is visualized and cleaned.
- The damaged or defective cartilage and bone at the recipient site within the same joint are carefully removed, creating a well-prepared bed for the graft.
- A healthy cartilage and bone graft, called an osteochondral plug, is harvested from a non-weight-bearing area of the patient’s joint.
- The osteochondral plug from the donor site is then precisely fitted into the prepared recipient site. The goal is to achieve a snug fit to ensure the graft integrates successfully.
Following surgery patients are discharged on the same day or within 24 hours after the procedure, making it an outpatient or short-stay surgery.
The immediate postoperative period involves managing pain and swelling. Patients are often advised to keep the surgical leg elevated to reduce swelling. Use of a cold-compression device such as GameReady is useful for pain and swelling control.
Physical therapy and rehabilitation are crucial components of recovery. After the surgery, patients are on crutches for 6 weeks and will undergo a structured rehabilitation program to gradually regain strength, mobility, and function in the affected joint. This aids in the healing process, restores joint mobility, and reduces the risk of complications.
Full recovery from OATS surgery can take 6-12months. The timeline varies depending on the extent of the procedure, whether any concomitant procedures were performed, and the individual patient’s healing process.
Schedule a knee consultation
Overall, OATS is an excellent option for the treatment of articular cartilage defects within the knee. Patients experience improved function, alleviation of pain and studies have shown that in athlete, it can provide a good rate of return to sports. Contact HyperRegen Sports Medicine in Toronto Canada to schedule a consultation to learn about knee cartilage defects and treatment options.
At a Glance
Dr. Jas Chahal
- Head of Orthopaedic Surgery, Women’s College Hospital
- Team Physician Toronto FC and University of Toronto Varsity Blues
- Associate Professor, University of Toronto Orthopaedic Sports Medicine Program
- Has more than 100 peer-reviewed publications
- Learn more
