Technique Corner: Particulate Cartilage

Particulate cartilage derived from allogeneic juvenile donors and minced cartilage derived from non-weight-bearing regions of autologous joints are novel single-staged treatment options for focal cartilage defects. As detailed in this technical guide, both strategies begin with finely mincing the donor cartilage. The focal defect is prepared by removing any compromised cartilage so as to achieve a stable shoulder of healthy cartilage. The calcified cartilage layer is subsequently removed without inducing bleeding from the subchondral bone. The particulated cartilage is secured within the prepared focal defect by fibrin glue, with or without further supplementation with an overlying biodegradable membrane. Post-operative rehabilitation entails the progressive increase in permitted joint motion and mechanical loading so as to consistently achieve graft binding, integration, and remodeling. While reports on clinical outcomes following single-staged particulated cartilage treatment of focal cartilage defects are limited, initial results have been promising.