BioCartilage: Background and Operative Technique

Damage to articular cartilage is prevalent and causes significant morbidity. A common initial treatment for focal, full-thickness articular cartilage defects is microfracture, which has been shown to have good to excellent short-term outcomes in appropriately indicated patients. Unfortunately, microfracture leads to the growth of fibrocartilage repair tissue rather than native hyaline-like cartilage and is less durable at longer-term follow-up. Efforts to augment repair and restore hyaline-like cartilage have led to the use of 2-stage procedures, such as autologous chondrocyte implantation, allografts, harvesting of autograft tissue, or complex scaffolds. An effective and reliable simple, single-stage method of cartilage restoration is needed. BioCartilageTM is a new product containing dehydrated, micronized allogeneic cartilage and is implanted with the addition of platelet rich plasma over a microfractured defect. Platelet rich plasma is shown to potentiate the cartilage repair process and is chemotactic for mesenchymal stem cells introduced following the microfracture procedure. BioCartilageTM is also an appropriate allogeneic cartilage scaffold with the proper biochemical makeup, including Collagen Type II and cartilage matrix elements. The procedure can be performed as a single-stage procedure with instrumentation and skill level consistent with standard microfracture techniques. The use of BioCartilage may create more hyaline-like tissue at the repair site vs microfracture alone. (C) 2013 Elsevier Inc. All rights reserved.