What is Articular Cartilage?
Articular cartilage is the smooth cartilage surface covering bones in joints contributing to smooth, pain-free motion. This cartilage surface can be damaged through acute trauma or by arthritis. Damage can lead to pain, swelling, or loss of motion. Damaged articular cartilage has a limited ability to heal on its own.

What is Articular Cartilage Paste Grafting?
Articular cartilage paste grafting (often abbreviated as art cart or paste grafting) is a minimally invasive, single arthroscopic procedure to stimulate regrowth of damaged articular cartilage surfaces. The arthritic area of the knee or where there is missing cartilage is morselized by the surgeon to create a fresh blood supply and to bring stem cells to the surface. The paste graft is harvested from the intercondylar notch (center of the knee), crushed into a paste, and impacted into the fractured chondral defect. The result is a repair technique that can provide durable cartilage repair tissue with long-term improvement in function and diminishment of pain.

How Long Has Articular Cartilage Paste Grafting Been in Use?
The paste grafting procedure was first performed by Kevin R. Stone, M.D. at The Stone Clinic in San Francisco in 1991.1

Who Can Benefit?
Articular cartilage is indicated for patients for primary treatment as well as for salvage of failed attempts to restore cartilage surfaces. Paste grafting is also indicated in patients with moderate to severe arthritis with a reasonable expectation of success. Many paste graft patients are appropriately hoping to delay artificial joint replacement; many are not appropriate candidates for other cartilage repair techniques due the size of the lesions or the severity of the arthritis.

What Are the Success Rates?
The results of our 2 – 12-year study2 (click here) reports a success rate of 85% in 125 arthritic patients.

What is the Recovery Time and Rehabilitation Program?

• Non-weightbearing for 4 weeks post-op (resting foot on floor and driving are okay)
• Patellar-Femoral or Trochlear lesions can bear full weight immediately
• Most patients will be in a hinged neoprene brace for support and to serve as a reminder not to bear any weight on that limb.
• Light to no resistance stationary cycling is okay at 2 weeks post-op.
• Low impact activities for 3 months post-op.
• Use of a Continuous Passive Motion machine (CPM) for 6 hours a day for 4 weeks is imperative.

For the complete 16-week rehabilitation protocol, please click here.

Related Publications

1. Stone KR, Walgenbach AW. Surgical technique for articular cartilage transplantation to full thickness cartilage defects in the knee joint. Oper Tech Orthop 1997;7:305-311
2. Stone KR, Walgenbach AW, Freyer A, Turek TJ, Speer DP. Articular Cartilage Paste Grafting to Full-Thickness Articular Cartilage Knee Joint Lesions: A 2- to 12-Year Follow-up. Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 22, No 3 (March), 2006: pp 291-299.
3. Stone KR, Walgenbach AW. Articular Cartilage Paste Grafting: Surgical Techniques and Initial Results. Journal of Sports Traumatology and Related Research, Vol. 20, No. 2, 1998.
4. Stone KR. Articular Cartilage Repair—The Paste Graft Technique. Surgery of the Knee-Third Edition, Insall JN, Scott WN, 2001.
5. Stone KR, Walgenbach AW, Smetana B. Salvage of Failed Knee Chondroplasty Using Articular Cartilage Paste Grafting. Postsurgical Orthopedic Sports Rehabilitation: Knee and Shoulder Manske, RC 2006
6. Stone KR, Walgenbach AW, Keller LE, Freyer A. Articular Cartilage Paste Grafting: Use in Primary Lesions and Failed Chondroplasty. Basic Science and Clinical Repair of Articular Cartilage Defects: Current Status and Prospects. In press.