About Articular Cartilage Regeneration with Stem Cell Paste Graft
Articular cartilage regeneration using stem cell paste grafting (often abbreviated as "art cart" or "paste grafting") is a minimally invasive, single arthroscopic procedure to stimulate the regrowth of damaged articular cartilage surfaces. The arthritic area of the knee, or area that 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 (non-weightbearing surface) of the femur, 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.

Articular Cartilage Regeneration with Stem Cell Paste Graft Overview Video

Candidates for Articular Cartilage Regeneration using a Stem Cell Paste Graft
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.

Success Rate of Articular Cartilage Paste Grafting
The results of our 2 – 12-year study (click here) reports a success rate of 85% in 125 arthritic patients.  Read the most recent peer-reviewed publication on articular cartilage paste grafting here.

Surgical Technique Video for Articular Cartilage Regeneration with a Stem Cell Paste Graft

	The area of chondral damage is first detected by MRI.
	At arthroscopy, the lesion is evaluated.
	The articular cartilage defect is treated by microfracture.
	Microfracture produces small holes in the lesion and stimulates bleeding to create a healing bed for the graft. An osteocartilaginous graft is harvested from the intercondylar notch in the center of the knee.
	The graft is morselized into a paste and inserted into the prepared area defect.
	The lesion is re-examined six months to one year later and usually is well healed.
	The new reparative tissue as evaluated by biopsy.
	Healing is also monitored by MRI.

Rehabilitation for Articular Cartilage Paste Grafting
Postoperatively, the knee is to be kept non-weightbearing for four weeks. A CPM (continuous passive motion) machine is used for six hours a day everyday for four weeks. A hinged, neoprene brace is used for support and to protect the knee in case of a fall. Deep water workouts, stationary bike immediately for the non-involved side and after two weeks for both legs are encouraged. Strengthening excercises that are non-weightbearing for the involved side are introduced and continued strengthening for the opposite side is also performed. Gradual return to full sports is permitted after three months, although impact excercises are discouraged as pain relief and graft maturity improves during the initial 12 months.

Rehabilitation Protocol for Articular Cartilage Stem Cell Paste Grafting