Sam Akhavan, MD
 Pittsburgh Orthopaedic Sports Medicine Doctor
 Arthroscopy Surgeon for Knee & Shoulder Surgery, Pain and Injuries
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Cartilage Injuries
   While not many things that were said in medicine over 150 years ago are still true in 2011, but the statement above would still apply today.  

  Articular cartilage is the lining of the knee and provides two smooth gliding surfaces during knee motion.  Injuries to cartilage occur typically as a result of trauma or generalized wear-and-tear.  If large portions of the knee are affected, the process is called arthritis.

  Cartilage lesions are among the most challenging injuries for the expert sports medicine surgeon.  We currently have many techniques for addressing these injuries depeding on the size and severity of these lesions.

  The goal of a microfracture is to create channels for blood to flow into the cartilage defect.  With appropriate rehabilitation, the clot will become a scar cartilage, in essence "filling the pot hole" created by the defect.  This technique can be performed arthroscopically.

Articular Cartilage transfer
  With this technique, Dr. Akhavan is able to take cartilage from a portion of the knee where it is not needed and transfer it to the defect.  This technique is excellent for filling small isolated defects but most of the time requires a small incision

Autologous Chondrocyte Implantation (ACI)
  This technique currently invoves two surgeries.  During the first surgery, a small amount of cartilage is taken from the knee and sent off to a lab where it is grown and expanded.  A second procedure  is then performed  bout 4-6 weeks later to insert the expanded cartilage into the defect.  
​  In order to perform this surgery, a special certification has to be obtained. Dr. Akhavan is certified for the performance of ACI.

Allograft Cartilage Transfer
  This technique involves transfering cartilage from a cadaver knee to fill the defect.  In some cases, this transfer can be performed using live cells  

Other Techniques
   Dr. Akhavan is currently involved in several clinical trials looking at the effects of various biological options for replacement of cartilage defects.
“…There are, I believe, no instances in which a lost portion of cartilage has been restored, or a wounded portion repaired, with new and well-formed permanent cartilage, in the human subject�
​                                                                                Sir James Paget, 1853

The Articular Cartilage of the knee
Articular Cartilage Defect
Click above for a video of a microfracture performed by Dr. Akhavan
Articular Cartilage Transfer to a cartilage defect
Harvest and reimplantation of an ACI procedure
A defect filled with an allograft cartilage transfer