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Cartilage Cell (Carticel) Technique

This image shows the steps of the Carticel technique. An arthroscopic procedure is done to harvest a small amount of the patient's healthy cartilage. Step 2, the cells are grown in culture. Step 3, about 6 weeks later a small incision is made in the knee and the damaged area of cartilage is removed. Step 4, at the same surgery, another small incision is made over the tibia (shin bone) and the periosteum (a layer of tissue over the bone is taken and sewn over the defect in the cartilage. Finally, the cartilage cell culture which is rich with new cells is injected under the periosteum and into the defect

In this technique, when the surgeon identifies the cartilage defects, he or she harvests cartilage from an area of the knee where it is not needed. The cells are then sent to Boston where a special cartilage cell growth technique is used. About six weeks later, the patient goes back to surgery, and a modest size incision is made into the knee directly over the defect. A second incision is made over the tibia (shin bone). The tissue which covers the tibia is called the periosteum. A small piece is harvested and then placed over the defect in the knee. Tiny stitches are used to attach this periosteum over the defect, and a biologic glue is also used to seal it. The concentrated, cultured cartilage cells are then injected under the periosteum and into the defect. Over the next several months, the cartilage cells grow and fill in the defect.

Dr. Clyburn likes to think of this as "seeding the lawn." Like the grass analogy, the cartilage grows evenly across the defect, but it takes a long time. Also, like the "seeded" lawn, it is important that the patient not walk on the defect until it is completely healed.