Name of the Procedure:

Common Name(s): Knee arthroscopy for cartilage harvest
Technical Term: Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) (HCPCS Code: S2112)

Summary

Knee arthroscopy for harvesting cartilage involves using a small camera and surgical instruments to collect cartilage cells from the knee joint. This surgery is typically minimally invasive and helps in regenerating cartilage for patients with cartilage damage.

Purpose

Medical Conditions Treated:

• Cartilage damage or degeneration
• Osteochondritis dissecans
• Knee osteoarthritis

Goals and Expected Outcomes:

• Harvest healthy cartilage cells for future implantation
• Promote cartilage regeneration
• Reduce knee pain and improve joint function

Indications

• Persistent knee pain or dysfunction not responding to conservative treatments
• MRI or other imaging showing localized cartilage damage
• Assessment by an orthopedic surgeon confirming suitability for the procedure

Preparation

• Patients may be instructed to fast for 12 hours before the procedure
• Medication adjustments, especially blood thinners, as advised by the healthcare provider
• Pre-procedure assessments like blood tests, ECG, or imaging studies

Procedure Description

1. Anesthesia: The procedure starts with administering local, regional, or general anesthesia.
2. Incision: A small incision is made near the knee to insert the arthroscope (a small camera).
3. Visualization: The camera allows the surgeon to visualize the inside of the knee joint.
4. Harvesting: Specialized instruments are inserted through other small incisions to remove small amounts of healthy cartilage.
5. Wound Closure: Incisions are closed with sutures or surgical staples.
6. Post-Procedure: Sterile dressings are applied, and the patient is moved to a recovery area.

Tools and Equipment:

• Arthroscope
• Small surgical instruments (e.g., shaver, grasper)
• Sterile dressings

Anesthesia:

• Local, regional, or general anesthesia depending on patient and procedure specifics

Duration

The procedure typically takes about 1-2 hours.

Setting

• Hospital operating room
• Outpatient surgical center

Personnel

• Orthopedic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurse
• Surgical technician

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Pain and swelling

Rare Complications:

• Deep vein thrombosis (DVT)
• Damage to surrounding structures (ligaments, nerves, blood vessels)
• Allergic reaction to anesthesia
• Joint stiffness

Benefits

• Reduction in knee pain
• Improved knee function and mobility
• Potential long-term cartilage regeneration and joint health
• Shorter recovery time compared to open surgery

Recovery

• Initial rest and immobilization of the knee
• Gradual increase in activity as guided by the surgeon
• Physical therapy to regain strength and flexibility
• Follow-up appointments to monitor healing
• Full recovery typically within a few weeks to months

Alternatives

• Physical therapy and medications for pain management
• Corticosteroid injections
• Microfracture surgery
• Autologous chondrocyte implantation (ACI) ##### Pros and Cons:
• Non-surgical options have fewer risks but may be less effective for severe damage
• Alternatives like ACI are more complex and involve multiple procedures

Patient Experience

During the procedure, patients under general anesthesia won't feel anything. If local anesthesia is used, they may feel some pressure but no pain. Post-procedure, patients might experience mild to moderate pain, manageable with prescribed pain medication. Comfort measures like ice packs and elevation of the leg can help alleviate discomfort. Most patients can walk with crutches immediately after the procedure.