Is the OATS knee procedure right for your cartilage repair?

Joint Health

by Kushal Patel, MD

Apr 11, 2023

The cartilage between the bones in your knee helps keep everything moving smoothly. But when there’s damage to this important cushion, even a small part, it can start to have a big impact on your ability to stay active. 

If you’re under 40 and dealing with cartilage damage in your knee, the osteochondral autograft/allograft transfer system knee procedure—or OATS knee procedure—could be an option. This surgery repairs the local area of damage with either your own or donor cartilage, helping you regain function, relieve knee pain and preserve knee health. Here’s what you need to know about the OATS knee procedure and whether it might be a good fit for you.

When to consider the OATS knee procedure

While many different injuries and conditions can lead to cartilage damage, the OATS knee procedure is only recommended for a specific group of people. Consider asking your doctor about this option if the following applies to you:

  • You have an injury or condition that affects the cartilage. The type of cartilage damage treated by the OATS knee procedure could be caused by any knee injury. It’s also common in adolescents with osteochondritis dissecans, in sports injuries where there is ligament or meniscus damage, or in people with conditions like sickle cell or autoimmune diseases.
  • Symptoms affect your daily life. Often, injuries to the cartilage don’t require an immediate need for the OATS knee procedure. It’s over time that the damage to the cartilage evolves. Symptoms like pain, stiffness, swelling or catching are signs that the injury needs treatment.
  • The damage is contained to a small, localized area. A good analogy is comparing the tread on a tire to the cartilage in your knee. If you have a tire tread that’s bald all the way around, this isn’t the procedure for you. If the tread only has an isolated hole in one area, the OATS knee procedure could help. We can replace areas of cartilage anywhere from 6-25 mm, or up to about an inch.
  • You’re younger than 40 years old. Most people who have the OATS knee procedure are younger than 40. For those between 40-45 years old, it may depend on your activity level and fitness. After 45, the procedure doesn’t have the longevity needed to be beneficial.  

What to expect during the OATS procedure

If your doctor recommends the OATS knee procedure for your cartilage repair, you can take steps to get prepared. Some people may consider therapy and exercises before surgery, known as prehab. Prehab helps you strengthen and tone the quadriceps to better support your knee. Your quadriceps, or quads, are the muscles that run from your hip to your knee on the front of your leg. 

The procedure itself takes between one to two hours and can often be performed with minimally invasive techniques. During the procedure, we remove the damaged area of cartilage and replace it with a plug of healthy cartilage. Usually, this healthy cartilage is taken from other areas of your own knee. For larger repairs, cartilage from a donor is also an option. 

After surgery, you can expect weight-bearing restrictions for about six to eight weeks and physical therapy for several months. You can return to impact activities and no restrictions typically within eight months. 

While some collegiate and professional athletes consider activity changes, in general, people return to their normal daily life with significant improvements in function and a reduction in pain. Moving forward, you can continue to keep your knee healthy with good hip and core strength, conditioning, and a stretching program to maintain good mechanics.

Proactive care for your knee health

Sometimes knee cartilage conditions can be treated with nonsurgical care. However, nonsurgical options often won’t help resolve symptoms or provide a lasting solution. That’s why we encourage people with this type of knee condition to address it sooner rather than later. 

When you don’t treat the damage in your knee, it may lead to more problems. If you wait too long to treat it, there’s also a chance that the OATS knee procedure might no longer be an option for you. 

In people who meet the criteria, the OATS knee procedure is critical to helping regain function. Even more, it’s about the preservation of your knee health. With the procedure, we’re able to prevent more damage and keep your knee joint healthy so you can continue an active lifestyle. 

Get knee care near you or take this quiz to see how healthy your knees are.

About the Author

Kushal Patel, MD, is an orthopedic sports medicine specialist on the medical staff at Baylor Scott & White Medical Center – Lake Pointe. He also serves as the medical director of sports medicine for the hospital. Dr. Patel is fellowship-trained in sports medicine and shoulder surgery, and specializes in cartilage repair and restoration.

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