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Presenter: Best to use OATS in smaller defects of the knee
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KOHALA COAST, Hawaii — Although microfracture is an easy and codeable procedure, according to a presenter here at Orthopedics Today Hawaii 2013, the procedure is of short-term benefit and future surgery may be compromised due to disruption of subchondral bone.
“OATS [osteochondral autologous transplantation system] is an optimal procedure in younger patients with lesions smaller than 2 cm, provides durable hyaline cartilage, outperforms microfracture, can be done as a single-stage procedure and is cost effective,” Jack M. Bert, MD, said.
He said that OATS results in normal hyaline cartilage subsequent to transplantation except at the perimeter of the defect and should theoretically yield the best long-term results since biopsy studies confirm normal hyaline cartilage at follow-up, he said. In addition, recently published studies confirm it is best to use OATS in smaller defects.
Jack M. Bert
“The bottom line is to be careful of putting multiple OATS grafts in a large area. Blood supply is poor between grafts, and collapse not uncommon,” Bert, an Orthopedics Today Editorial Board member, said.
He also said that in a multicenter study review, there was a significantly greater return to higher level activity levels after OATS compared to microfracture.
Reference:
Bert JM. The treatment of small symptomatic lesions. Presented at: Orthopedics Today Hawaii 2013; Jan. 13-16, 2013; Kohala Coast, Hawaii.
Disclosure:
Bert is a consultant for Exactech, Exscribe, Sonofi (Genzyme), Smith & Nephew, Tornier, and Wright Medical Technology.