Osteochondral autograft transfer is indicated for cartilage lesions from 1. Microfracture and figure 1 full thickness articular cartilage lesion on the femoral condyle of the knee, exposing the subchondral bone plate. Knee microfracture, mosaicplasty and osteochondral. Current concepts in the rehabilitation following articular.
Shoulder arthroscopy general slap or anterior labral repair. There was such limited information on rtp within the one oca study that no signi. Most candidates for articular cartilage restoration are young adults with a single injury, or lesion. Nonweight bearing in a splint with strict elevation week 26.
The oats procedure is currently the only procedure that restores the normal hyaline articular cartilage to the injured knee. Microfracture and chondroplasty procedures aempt to. The osteochondral autograft transplantation oats procedure involves transplantation of plugs of. Older patients, or those with many lesions in one joint, are less likely to benefit from the surgery. A small amount of juvenile donor articular cartilage is harvested, tested, and stored as 1 mm cubicles. Oats stands for osteochondral autograft transfer system, and the technique is very similar to mosaicplasty. San franciscofebruary 8, 2012 a new study has demonstrated that a procedure wherein healthy cartilage is transplanted to fix an area of damaged cartilage osteoarticular cartilage transplantation or oats procedure is superior to the standard of care for repairing cartilage defects. Had an mri done today and found out the surgery was not successful. Gait, edema, rom, strength, ligament laxity and tenderness. Oats undergoing a concomitant procedure in 60% of cases.
The oats procedure, an abbreviation for osteoarticular transfer system, is a surgical procedure used to treat focal cartilage defects. The procedure is considered less technically demanding than oats or. Last august i had left ankle orthroscopic surgery to try to correct an ocd lesion. Oats knee surgery procedure at detroit medical center. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Ankle oats procedure protocols postsurgical timeline. To serve as a guide to physical therapy following your surgery, this section contains rehabilitation protocols specific to your procedure. Learn the osteochondral grafting of the talus oats procedure surgical technique with step by step instructions on orthoracle. Please note these are meant to be guidelines for rehabilitation to be followed by a certified physical or occupational therapist. Ankle pumps progress to plantar flexion with resistance band. They are most commonly located posteromedially 57% or anterolaterally 43%, while centrally located lesions are uncommon 3. Training of the trunk, hip, and ankle musculature is.
My os recommended today that the next best step is to have the oats procedure done. Osteochondral autografts mosaicplasty, oats medical. Oats of the ankle is a surgical procedure to treat osteochondral lesions of the talus ocl or osteochondritis dissecans ocd. Hi, the oats procedure, osteoarticular transfer system, is a surgical procedure used to treat focal cartilage defects. Because of the nature of the procedure, damage sizing beyond 10mm to 20mm in diameter may not be a viable case for oats. But, it still was painful not to have a chair or something to rest your leg on at least level with the chair you are sitting on. Repair of adult human cartilage a significant challenge. Rehabilitation protocol following osteochondral allogra3. During the oats procedure, the osteochondral grafts are harvested from the knee and immediately used to repair the talar lesion. Non weight bearing to toe touch weight bearing with crutches with brace for 56 weeks specified by the m. Postoperative instructions osteochondral autograft procedure. What is the osteoarticular transfer system procedure. The oats procedure is currently the only procedure that restores the normal hyaline arcular carlage to the injured knee. This code will cover the right ankle arthroscopy, oats procedure, medial talus, with.
Careful observation and ongoing assessments will dictate progress. Utilize cpm for at least 4 weeks unless otherwise instructed by m. Rehabilitation and return to play following osteochondral. The oats procedure is generally for individuals under 50 years of age and experiencing knee pain and swelling from cartilage damage or loss. The sports physical therapy service is an integral part of the sports medicine center and the department of. A joint restorative procedure using oats was developed. Straight leg raisesankle pumps phase ii weeks 68 weightbearing. Disadvantages with the oats procedure include the limited. Brostrom procedure rehab protocol time frames mentioned in this article should be considered approximate with actual progression based upon clinical presentation.
You report this with code 28446 open osteochondral autograft, talus includes obtaining grafts. Arthroscopic orthopedic surgical video of autograft oats of the knee from san francisco orthopaedic sports medicine surgeon dr. A stepwise approach for osteochondral lesions of the talus. Osteochondral allograft transplantation in the ankle. Ankle pump using rubber tubing, quad sets, multiangle isometrics, active knee extension no resistance, slr, stationary bike when rom allows, biofeedback and electrical muscle stimulation, prn. Take an aspirin each morning, wear an elastic stocking ted below the knee, and do at least 10 ankle pump exercises each hour to help prevent phlebitis blood clots in the veins. Each surgical modality has its indications as well as pros and cons. Mosaicplasty uses cartilage from undamaged areas of the joint, and moves this cartilage to a damaged area. For the oats on the ankle or foot, the only coding option for you is 29999 unlisted procedure, arthroscopy.
Rehabilitation protocol allograft articular cartilage transplant patella andor trochlea description of procedure. Return to normal activities of daily living month 612. Gary gilyard helps a dedicated hockey player with a devastating knee injury get back on the ice. All plugs will be removed from nonweight bearing areas. Our elearning platform contains high resolution images and a certified cme of the osteochondral grafting of the talus oats. Oats procedure new york, ny knee cartilage east hills, ny. Partial weight bearing in cam walker boot and begin formal physical therapy month 35. The disposable donor and recipient cutting tube sets of the singleuse osteochondral autograft transplant system oats kit facilitate harvesting of various diameter osteochondralhyaline cartilage cylinders from a donor site superior and lateral to the femoral notch or above the sulcus terminalus. Protect the cartilage transfer avoid weight bearing if instructed to do so 2. Osteochondral lesions of the talus are being recognized as an increasingly common injury, and may occur in up to 50% of acute ankle sprains and fractures, particularly in association with sports injuries 1, 2. Oats is one technique of several used to treat this problem. The osteochondral autograft transfer system oats is a procedure employed for medium sized areas of discrete damage mosaicplasty is employed for even larger but discrete areas of damage.
Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to. Additional surgery after the index procedure is common, with ankle. Sports medicine physical therapy rehabilitation protocols. Gill approximately ten to fourteen days after your surgery. During the act procedure, cartilage from the knee is harvested. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Find pdfs of our most common rehabilitation protocols. The knee is the most common area for cartilage restoration. The oats procedure is a more invasive technique and requires a donor site. Currently, there are many procedures for the treatment of osteochondral lesions of the talus. During the oats procedure a single plug is taken from the patient versus several plugs being removed during the mosaicplasty. Continue strengthening exercises three times per week continue flexibility exercises daily. Full text osteochondral allograft transplantation in the ankle. Rehabilitation protocols ohio state sports medicine.
Microfracture, mosaicplasty, oats pag e1 of 3 revised 21201611 knee microfracture, mosaicplasty and osteochondral autograft transplant oats. In the oats procedure, the plugs are usually larger, and therefore only one or two plugs are needed to fill the area of cartilage. When compared to oatsmosaicplasty, allograft has no donor site morbidity. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. You will go home with crutches, cryocuff cold therapy unit and a cpm machine. You should do at least 10 ankle pump exercises each hour. At the university foot and ankle institute, we have been following a stepwise.
The authors noted an overall rtp rate of 73%, with microfracture having the lowest rtp rate at 66%, followed by 67% for aci, and 91% for oats. Osteochondral autograft transplantrehabilitation protocol weightbearing brace rom therapeuticexercises phase i0 6 weeks nonweightbearing 0 1 week. New procedure bests standard of care for fixing damaged. Osteochondral ankle oats surgery five years later, wondering if surgery was mistake hi all im writing in with some thoughtsquestions about a problem that is probably a mix of physical issues and my tendency towards depression and being angry at myself. Osteochondral grafting of the talus oats procedure. Rehabilitation guidelines after surgery, sports medicine. In our practice, we evaluate the advantages and disadvantages of each procedure, determining which is best. Osteochondral allograft of the talus pubmed central pmc.