Orthopedics Hip & Knee Surgical Procedures Cartilage Transfer Surgery of the Knee What is Cartilage Transfer Surgery? By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on July 09, 2022 Medically reviewed by Oluseun Olufade, MD Medically reviewed by Oluseun Olufade, MD LinkedIn Twitter Oluseun Olufade, MD, is a board-certified orthopedist. He teaches as an Assistant Professor of Orthopedics at Emory School of Medicine in Atlanta, Georgia. Learn about our Medical Expert Board Fact checked by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print Osteochondral autograft transfer system (OATS) and mosaicplasty are surgeries that are done to treat severe cartilage damage in the knee joint. These procedures involve autologous (from your own body) transfer of cartilage from healthy areas to damaged areas. You have a number of treatment options if the cartilage in your knee joint is damaged. Typically, treatment begins with non-invasive approaches, such as pain medication and physical therapy. If these treatments are not effective, more invasive treatments, including surgical options, might be necessary. If you have small, isolated areas of cartilage damage, a cartilage transfer surgery could be considered. This photo contains content that some people may find graphic or disturbing. See Photo Markus Moellenberg / Getty Images Cartilage Transfer Surgery During these procedures, cartilage is taken from non-weight-bearing areas of the knee. The idea behind this approach is that the body will not miss this cartilage and it can be used where it is needed. Over time, the holes left from where the plugs are taken will fill with bone and scar tissue. Mosaicplasty: During mosaicplasty, your surgeon moves round plugs of cartilage and underlying bone to damaged areas.The plugs are each a few millimeters in diameter, and when multiple plugs are moved into a damaged area, the small plugs of cartilage look like mosaic tiles.OATS: The plugs used in an OATS procedure are larger than those used in mosaicplasty, and only one or two plugs are used to fill the area of cartilage damage. Performing Cartilage Transfer Surgery Prior to your cartilage transfer procedure, your surgeon will inspect your knee joint arthroscopically (with a small incision and a small camera) to see if you have an area of cartilage damage that is suitable for cartilage transfer. Steps of your procedure: The first step is the preparation of the area of damaged cartilage. A coring tool is used to make a perfectly round hole in the bone in the area of damage.The next step is harvesting the plug of normal cartilage. The plug is taken with the underlying bone and sized to fit snugly into the hole that was prepared in the area of damage.The final step is the implantation of the harvested plugs into the hole that was created in the damaged area. Over time, the implanted bone and cartilage should incorporate into its new environment. Cartilage transfer surgical procedures are done arthroscopically in an operating room, but there is no overnight stay in the hospital. The surgery can be done either under general anesthesia, a regional nerve block, or with both for pain control. Recovery After surgery, your leg will likely be placed into a brace, and you will be given crutches or a walker to prevent you from having to place weight on your surgical leg. A typical recovery following cartilage transfer surgery takes approximately six to nine months. The first few months are the most arduous in terms of rehabilitation and recovery. Activity Once your surgeon feels that it is safe for you to place weight on your surgical joint, you will gradually increase the amount of weight-bearing on the healing joint. Most surgeons will not allow any competitive sports activities until at least six months after surgery. Before you can go back to athletic activities, your surgeon will confirm that you have regained full mobility and strength. Complications The most common risks of knee arthroscopy include infections and blood clots. These are uncommon complications, but when they do occur, they can be serious. After cartilage transfer surgery, there is a possibility that the transfer cartilage might not remain healthy. Another possible complication is pain at the site where the healthy cartilage was obtained. Your surgeon will try to only obtain cartilage from areas where your knee does not need protection. However, some people report donor site pain after the procedure. A Word From Verywell Cartilage transfer surgery is a possible treatment option if you've had small, contained areas of cartilage damage within your knee joint. This same surgical procedure has also been used in other joints, but it is by far most common in the knee joint. If you have cartilage damage due to widespread arthritis, you would not be a candidate for a cartilage transfer procedure. Successful outcomes from cartilage transfer surgery are most dependent on careful surgical technique and compliance with postoperative precautions. 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Sabaghzadeh A, Mirzaee F, Shahriari Rad H, Bahramian F, Alidousti A, Aslani H. Osteochondral autograft transfer (Mosaicplasty) for treatment of patients with osteochondral lesions of talus. Chin J raumatol. 2020;23(1):60-62. doi: 10.1016/j.cjtee.2019.12.001 Hindle P, Hendry JL, Keating JF, Biant LC. Autologous osteochondral mosaicplasty or TruFitTM plugs for cartilage repair. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1235-1240. doi: 10.1007/s00167-013-2493-0 Rowland R, Colello M, Wyland DJ. Osteochondral autograft transfer procedure: arthroscopic technique and technical pearls. Arthrosc Tech. 2019;8(7):e713-e719. doi: 10.1016/j.eats.2019.03.006 Bonazza NA, Smuin DM, Joshi R, et al. Surgical trends in articular cartilage injuries of the knee, analysis of the truven health marketscan commercial claims database from 2005-2014. Arthrosc Sports Med Rehabil. 2019;1(2):e101-e107. doi: 10.1016/j.asmr.2019.08.002 Richter DL, Schenck RC, Wascher DC, Treme G. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health. 2016;8(2):153-160. doi: 10.1177/1941738115611350 Büttner B, Mansur A, Hinz J, Erlenwein J, Bauer M, Bergmann I. Combination of general anesthesia and peripheral nerve block with low-dose ropivacaine reduces postoperative pain for several days after outpatient arthroscopy: A randomized controlled clinical trial. Medicine. 2017;96(6):e6046. doi: doi: 10.1097/MD.0000000000006046 Camp CL, Stuart MJ, Krych AJ. Current concepts of articular cartilage restoration techniques in the knee. Sports Health. 2014;6(3):265-273. doi: 10.1177/1941738113508917 Wagner KR, Kaiser JT, DeFroda SF, Meeker ZD, Cole BJ. Rehabilitation, restrictions, and return to sport after cartilage procedures. Arthroscopy, Sports Medicine, and Rehabilitation. 2022;4(1):e115-e124. doi: 10.1016/j.asmr.2021.09.029 Clement RC, Haddix KP, Creighton RA, Spang JT, Tennant JN, Kamath GV. Risk factors for infection after knee arthroscopy: analysis of 595,083 cases from 3 united states databases. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2016;32(12):2556-2561. doi: 10.1016/j.arthro.2016.04.026 Perrotta C, Chahla J, Badariotti G, Ramos J. Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy. Cochrane Database of Systematic Reviews. 2020;(5). doi: 10.1002/14651858.CD005259.pub4 Andrade R, Vasta S, Pereira R, et al. Knee donor-site morbidity after mosaicplasty – a systematic review. Journal of Experimental Orthopaedics. 2016;3(1):31. doi: 10.1186/s40634-016-0066-0 Additional Reading Mundi R, Bedi A, Chow L, Crouch S, Simunovic N, Sibilsky Enselman E, Ayeni OR. Cartilage Restoration of the Knee: A Systematic Review and Meta-analysis of Level 1 Studies. Am J Sports Med. 2016 Jul;44(7):1888-95. By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit