Cartilage Restoration

You don’t have to live with joint pain

Cartilage problems are the most common source of knee pain. Left untreated, they can lead to further joint deterioration and arthritis.

Joint pain is your body’s warning signal that something is wrong. Ignore it, and what might have been a small problem can lead to more serious complications.

Cartilage problems are one of the most common causes of knee problems. Fortunately, there are many treatment options available, including some newer technologies that have only recently been developed.

The orthopedic specialists at Aurora BayCare use the latest minimally invasive techniques to repair and replace damaged cartilage. Our goals are to help you alleviate your pain, regain joint function, and stop further deterioration. 

Our orthopedic specialists are recognized as innovators in cartilage restoration.  We were among the first providers in the nation to use minimally invasive cell-based cartilage transplants to repair cartilage damage in the knee. 

Cartilage repair and restoration options include:

  • Marrow stimulation – microfracture chondroplasty
  • OATS – osteochondral autograft
  • Carticel transplant – autologous transplant (your own tissue)
  • DeNovo NT – allograft (donor tissue transplant)

Marrow Stimulation

The most commonly performed cartilage repair procedure, microfracture chondroplasty, is a marrow stimulation technique.  It involves using picks or drills to make your subchondral bone bleed.  This stimulates fibrocartilage to fill in the affected area. 

Marrow stimulation is successful in 75% to 80% of patients who have small, well-contained damage, a more recent onset of symptoms, and who are less than 40 years old.

OATS Procedure

With OATS (osteochondral autograft transfer system), a plug of your own cartilage and bone is harvested from a healthy joint surface and transplanted into the damaged area.  Over time, viable cartilage cells integrate and cover the damaged area.

Developed in the early 90s, the OATS technique has produced excellent results.  The OATS technique is limited by the size of the affected area and size and number of donor plugs available.

Carticel Cartilage Transplant

Another option for cartilage repair using your own cartilage is a Carticel transplant.  In this procedure, your harvested cartilage cells are sent to a specialized lab to grow.  After about six weeks these cells will have grown enough to proceed with surgery.

The Carticel procedure is most common in younger patients, including adolescents, because of its extensive durability. Studies show that even 10 years after the procedure, as many as 75% to 85% of patients are still experiencing excellent results.

Carticel has been approved for use in the U.S. for about 13 years, but is still not widely available. Aurora BayCare is the only Carticel provider in Northeast Wisconsin. One of our orthopedic surgeons not only offers the Carticel procedure but also teaches other physicians how to perform this state-of-the-art cartilage restoration surgery.


As an alternative to harvesting your own cartilage, cartilage restoration procedures can be performed using an off-the-shelf product called DeNovo NT (Natural Tissue).  DeNovo Natural Tissue is harvested from organ donors, typically under the age of 12. Juvenile cartilage has a far greater success rate for regeneration.

By using donor cartilage, the surgery is reduced to a one-step process. There’s no need to harvest your own cartilage and wait for it to grow. With donor cartilage, you also remove the risk of damaging your own healthy tissue.

The orthopedic surgeons at Aurora BayCare have been using DeNovo NT in knee repairs since 2009, shortly after the product launched.

Relieving Joint Pain

Sometimes, cartilage is so damaged that cartilage restoration is not possible. In those cases, other options such as prosthetic resurfacing or total joint replacement may be more appropriate.

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