OATS Knee Surgery: A Reliable Knee Treatment Option

Osteochondral Transfer System Knee Surgery - A Reliable Knee Treatment Option

Osteochondral Autograft Transfer System (OATS) knee surgery is a treatment option developed in the early 20th century for treating patients with knee complications. Today, it is considered as a salvage treatment option when other cartilage repair procedures fail to give the desired results. So what it is exactly? OATS involves moving healthy cartilage from a non-weight bearing area of the knee to replace a damaged weight bearing cartilage in another area of the knee. If you are interested in learning more about this type of knee surgery, keep reading.
Naturally, the knee joints are lined with a smooth, tough substance referred to as cartilage. The cartilage helps our joints to glide smoothly and be able to carry us without any feelings of pain, giving us the flexibility required to move our legs. However, as we get older or engage in some sporting activities, the cartilage starts to experience the “wear and tear” and as a result, we start to feel pains, stiffness, and swelling of the knee joint. Of course, healthy knee joints are crucial to the fulfilment of our day to day activities. In fact, the pains and difficulties that often accompany knee injuries can have negative impacts on our productivity and overall well-being if not quickly addressed.
The reality is nearly anyone can suffer from knee complications, which may be as a result of ‘wear and tear’ or injuries that affect the cartilage. As mentioned earlier, age, weight, genetic predisposition, intense motion sports, accident, and trauma, among other things, are some of the factors that may lead to cartilage defects. The good news is that whatever may be the cause, osteochondral transfer system knee surgery has been found to be a corrective and dependable procedure in many instances. However, not all knee problems may require the conduct of an osteochondral transfer system knee surgery.
Osteochondral Autograft Transfer System Knee Surgery

Conditions That May Warrant OATS Knee Surgery

The criteria for selecting patients that are eligible for osteochondral transfer have not really been defined. However, medical consensus supports the use of osteochondral transfer for patients who may have fulfilled all or some of the following criteria.

  • Exhibit a symptomatic and weakening focal chondral lesions of an articular surface of the knee.
  • Situations where previous medical and surgical treatments failed to work.
  • A situation where total knee replacement is not considered a viable option.
  • Patients who are ready to undergo an extensive period of non-weight bearing and rehabilitation associated with the surgery.
  • Patients who are not suffering from an inflammatory joint disease.
  • Patients without a steroid-induced cartilage or bone disease.
  • People without extensive osteoarthritis condition.
  • People who are not suffering from misalign joint or joint instability.

If you meet the above pre-surgical conditions, you’re a good candidate for osteochondral transfer knee surgery. Untreated cartilage defects may progress to osteoarthritis, which is always accompanied by pain and joint dysfunction. It is, however, important that you understand the procedures involve before you proceed with the surgery.


How It Works

The procedure for the osteochondral transfer system knee surgery involves harvesting and transferring a plug of healthy bone and cartilage from a place of lesser weight-burden in the knee joint (with a cylindrical coring device) to the symptomatic osteochondral defect area of the knee. The surgery often follows arthroscopy procedure where the surgeon uses a fiber-optic viewing instrument, which has a tiny lens, a light source, as well as a video camera. The arthroscopic instrument allows the surgeon to visually examine the knee so the incision of the knee can accurately be performed to give way for the implant.
Once the incision is done, the surgeon prepares the damaged area of cartilage and then implants the harvested plug of healthy cartilage and bone from the non-weight bearing part of the knee into the damaged area. If the procedure is successful, overtime the surgery will help to relieve pain and restore normal movement and functions to the joint. Full recovery may take minimum of 5-6 months.
Basically, there are two different ways to conduct osteochodral knee surgery. These are allograft and autograft osteochondral transfers. The osteochondral allograft procedure describes a situation where the cartilage used for treating a patient comes from another individual donor. Patients may experience a delay in this instance if the donor cartilage is not available. This method also involves the risk of disease transmission.
On the other hand, osteochondral autograft involves the transfer of healthy cartilage taken from a less-weight-bearing donor site on the patient body and transferred to a defect area of the knee. This procedure has the advantage of graft availability and absence of possible disease transmission. However, the donor site may experience morbidity for a while after the surgery. The donor site should be approximately 1 cm in size if not less in order to minimize morbidity complications on the area where the cartilage was transferred from. To see this procedure live, have a look at the following video:

2016 Osteochondral Allograft | Brian Cole, MD, MBA


How to Prepare for OATS Knee Surgery

If you are planning to embark on an osteochondral transfer system knee surgery, there are certain things you need to do in preparation for the procedure so you can have a successful post-surgery experience. In most instances, patients who undergo osteochondral transfers are usually advised to reduce their weight prior to the surgery and be prepared to use a continuous passive motion (CPM) machine for at least 6-8 hours a day as part of their rehabilitation routine during the 6 weeks post-surgery non-weight-bearing period.

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Post-Surgery Recovery

When you wake up in the recovery room after the surgery, you will see a bandage around the operated knee. The bandage may be removed the following day while the steri-strips are left in place to fall off later. You may experience some knee-swelling post-operative and may have to be on crutches for 6 to 12 weeks after surgery before you can bear weight on the operated joint again. Generally, it recommended that patients stay away from full activities until they have regained their strength.


We hope that you found this post useful and that you know a little more about osteochondral transfer system as a knee treatment option, than when you came to us. Is it a viable option for your situation? The only way to find out is to consult with your health care practioner and go through all possible treatment options, to discuss the pros and cons. Then you can make your decision.
If you have gone through this type of surgery before, we’d love to hear from you. Did it actually help? Is there anything you think our readers should know? Just use the comment box below. Also, don’t forget to check out our post op knee braces before you go.
Disclaimer – We are not doctors here at The Best Knee Braces and are not qualified to provide medical advice. The information on Osteochondral Autograft Transfer System (OATS) knee surgery above was posted for informational purposes only and should not be interpreted as medical advice.

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2 thoughts on “OATS Knee Surgery: A Reliable Knee Treatment Option

  1. I had an oats procedure on my right knee about 14 yrs ago. but now my left knee has a torn mesnicus and they are going in arthro to repair. but since my left knee went out, now my right is starting to hurt. does this mean I need replacement? or maybe when left one gets done it will be easier and get back to normal with the right. I was always under the impression that oats procedure was just a delay tactic for replacement. I was 51 and doctor said I was too young for replacement at that time.

    1. Hi Lana – If your right knee is starting to hurt now, it could be because you hurt your left side and you might be compensating and shifting your weight more to your right side when you walk, go up/down stairs, etc. Getting the left one fixed might do the trick, but it’s going to take time to really find out. I did something similar a year ago… my bad left knee (due to a hyperextension injury) was actually doing a lot better but then I tore my achilles on the right side. Within a month of hobbling around and putting too much weight on the left side, my left knee started to hurt again. I had to work hard at building strength in both legs and it’s better now. All that to say, it’s hard to say whether you are ready for a replacement. Maybe some physiotherapy is all you will need, but I would consult your doctor to see what they think. Good luck.

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