Cartilage Repair
in Singapore

Microfracture and nanofracture are commonly used minimally invasive techniques for treating small, localised cartilage defects. During the procedure, the surgeon creates tiny holes in the subchondral bone beneath the damaged cartilage. This allows bone marrow cells to enter the defect and form new cartilage-like tissue that helps cover the exposed area.

The goal of the procedure is to stimulate the formation of fibrocartilage, which can provide a protective surface over the damaged region and help reduce symptoms. However, fibrocartilage is not identical to the original hyaline cartilage found in healthy joints and may be less durable over time. For this reason, the procedure is generally considered for smaller cartilage defects, particularly in younger patients.

Osteochondral Autograft Transfer, also known as OATS, involves transplanting healthy cartilage and the underlying bone from another part of the patient’s joint. The graft is usually taken from a non-weight-bearing area and placed into the damaged site to restore the joint surface.

Because the transplanted tissue contains natural hyaline cartilage, the goal is to reconstruct the defect with cartilage that closely resembles the original joint surface. This technique is often considered for small to moderate cartilage defects where healthy donor tissue can be safely harvested. However, the amount of cartilage that can be taken from the patient’s own joint is limited, which may restrict its use for larger defects.

Osteochondral allograft transplantation is typically used for larger or more complex cartilage injuries. Instead of using tissue from the patient’s own joint, this procedure uses cartilage and bone from a donor graft. The graft is shaped to fit the damaged area and implanted to restore the joint surface.

The goal is to replace extensive cartilage damage with mature cartilage that can help improve joint function and reduce symptoms. This approach can be useful when the defect is too large for autograft techniques. However, the availability of suitable donor tissue may be limited, and there is a small risk of immune response or graft-related complications.

Autologous Matrix-Induced Chondrogenesis (AMIC) is a cartilage repair technique that builds on the principles of microfracture. After the surgeon prepares the cartilage defect and performs microfracture or nanofracture to release bone marrow cells, a bioresorbable collagen scaffold is placed over the treated area.

This scaffold helps stabilise the clot formed by the bone marrow cells and provides a structure that supports cell attachment and growth. The aim is to encourage the formation of cartilage-like tissue that may resemble hyaline cartilage more closely than microfracture alone. AMIC is often considered for medium-sized cartilage defects, particularly in younger and more active individuals.

Arthroscopic debridement and lavage is a minimally invasive procedure that focuses on improving joint symptoms rather than regenerating cartilage. During the procedure, the surgeon removes loose cartilage fragments, smooths rough cartilage surfaces and flushes the joint with fluid.

The goal is to reduce mechanical irritation within the joint, which may help relieve symptoms such as catching, locking or discomfort during movement. This procedure is sometimes considered for early-stage cartilage damage or when other cartilage repair techniques are not suitable. However, it does not restore damaged cartilage and is generally associated with short-term symptom relief rather than long-term regeneration.