Osteochondritis Dissecans (OCD) of the knee is yet another elusive disease. It commonly affects adolescent age group and remains silent for many years till the diseased bony fragment gets separated from its base and becomes the loose body. The separated bony piece also separates with its cartilage covering. This separated piece is medically called as osteochondral fragment or OC fragment. Sometimes, such separated and dead OC piece are so large that they create a huge defect in the knee joint at a very young age. A boy of 13 years old approached us in 2010 with such a large defect. He had been to many prominent doctors but could not find the suitable solution.
Dr Goyal offered him, our innovation technique called ‘The Overlay ACI Technique’. A small piece of cartilage from the healthy part of his knee was taken and sent for culturing of the cartilage cells to a Korean Lab. The small piece of health cartilage contained roughly 200 cartilage cells (Chondrocytes). After 1 month, the lab dispatched around 10000000 cultured cartilage cells ready for implantation in young boy’s knee. We opened the disease area and found that the OC defect in his knee was very huge and was nearly of 15cm2 in size. The defect was very big and deep. Dr Goyal decided to do bony reconstruction and used some extra bone from his iliac crest to fill the bony defect. Over the filled bony defect, he implanted the cultured cartilage cells. Thus he created a new technique where simultaneous single stage bony reconstruction and cartilage reconstruction was carried out. That too, in a small child of 13 years!!!
We were very happy to examine the patient at 2 years post surgery where he was totally pain-free and was enjoying his school and sports activities. We felt proud when the leading newspaper, Ahmedabad Mirror, took notice of such important milestone surgery and published two years follow up report in its print edition and electronic edition on 9th February’ 2012. The said patient is now 17 years old and is studying in college. He is active sports player and plays cricket and football regularly. The more than 4 years follow up is a testimony of success of this innovative surgery from Saumya Orthocare.
SO Team, 2015. ©
