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Treatment options

Several procedures can help repair an articular cartilage injury in your knee. Your doctor can help you decide which treatment option is best for you based on your age, as well as the location and size of the cartilage injury and your expectations.

Remember, if you postpone treatment, your injury and associated knee pain may get worse and over time may become more difficult to repair.

Articular Cartilage Repair

Arthroscopic Chondroplasty (Debridement and Lavage)

During an arthroscopic procedure, the surgeon locates and trims the damaged cartilage, then irrigates the area with sterile water. This cleaning of the joint surface may also be referred to as “debridement and lavage.” Chrondoplasty may relieve pain, but this treatment does not actually repair the damaged cartilage.

Marrow Stimulation Repairs (Abrasion Arthroplasty, Microfracture, Subchrondal Drilling)

These procedures are used to repair small cartilage injuries. They allow the body’s own marrow stem cells to produce scar tissue and repair the damaged cartilage. The surgeon uses a surgical instrument to create tiny holes or breaks in the bone underneath the damaged cartilage. Blood seeps out of these fractures and creates a clot that releases cartilage-building cells. The most common marrow stimulation procedure is called microfracture.

Osteochondral Autograft

To repair small cartilage injuries, the surgeon can remove a small plug of a patient’s own healthy cartilage from a non-weight-bearing area of the knee joint and insert it into the injured area. This treatment is similar to a hair-plug transfer.

Osteochondral Allograft

For very large cartilage injuries and those that involve bone and cartilage loss, the surgeon may obtain tissue from a donated cadaver. The implant contains portions of both bone and cartilage, and may provide relief from injuries that penetrate the bone.

CARTICEL and Autologous Chrondrocyte Implantation (ACI)

CARTICEL is a biologic product used to repair articular cartilage injuries in adults who have not responded to a prior arthroscopic or other surgical repair procedure. It uses your body’s own cultured cells to form new hyaline-like cartilage in your knee following a surgical procedure called autologous chondrocyte implantation (ACI). CARTICEL is the name of the cells that are grown from the samples (or biopsy) taken from your knee. CARTICEL poses little risk of disease transmission to you since it comes from your own tissue. CARTICEL is not indicated for the treatment of cartilage damage associated with generalized osteoarthritis.

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Indication

Carticel® (autologous cultured chondrocytes) is an autologous cellular product indicated for the repair of symptomatic cartilage defects of the femoral condyle (medial, lateral or trochlea), caused by acute or repetitive trauma, in patients who have had an inadequate response to a prior arthroscopic or other surgical repair procedure (e.g., debridement, microfracture, drilling/abrasion arthroplasty, or osteochondral allograft/autograft).

CARTICEL should only be used in conjunction with debridement, placement of a periosteal flap and rehabilitation. The independent contributions of the autologous cultured chondrocytes and other components of the therapy to outcome are unknown.

CARTICEL is not indicated for the treatment of cartilage damage associated with generalized osteoarthritis.

CARTICEL is not recommended for patients with total meniscectomy unless surgically reconstructed prior to or concurrent with CARTICEL implantation.

Important Safety Information

CARTICEL should not be used in patients with a known history of hypersensitivity to gentamicin, other aminoglycosides or materials of bovine origin.

It should not be used in patients who have previously had cancer in the bones, cartilage, fat or muscle of the treated limb.

Pre-existing conditions, including meniscal tears, joint instability, or malalignment should be assessed and treated prior to or concurrent with CARTICEL implantation.

CARTICEL is not routinely tested for transmissible infectious diseases and may transmit disease to the healthcare provider handling CARTICEL.

Use of CARTICEL in children, patients over age 65, or in joints other than the knee has not yet been assessed.

The occurrence of subsequent surgical procedures (SSPs), primarily arthroscopy, following CARTICEL implantation is common. In the Study of the Treatment of Articular Repair (STAR), forty-nine percent (49%) of patients underwent an SSP on the treated knee, irrespective of their relationship to CARTICEL, during the 4-year follow up. The most common serious adverse events (≥5% of patients), derived from STAR, include arthrofibrosis/joint adhesions, graft overgrowth, chondromalacia or chondrosis, cartilage injury, graft complication, meniscal lesion, graft delamination, and osteoarthritis.

For more information on CARTICEL, please see the Package Insert (PDF).

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Check out our FAQs for answers—or contact a Carticel Care^® Coordinator at 800-453-6948, Option #2, for more detailed information.

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