| Complications
and Current Problems with OATS
At
present, we are trying to overcome some of the limitations
of OATS. These include the availability of donor grafts,
the integration of donor-donor and donor-recipient hylane
cartilage interface, and the ability of OATS to handle
different sizes and depths of defects. Furthermore, donor
site morbidity has also been a concern with complications
including pain, avascular necrosis and fracture (both
condylar and graft fracture, possibly leading to loose
bodies in the joint). Surgical complications are also
a consideration with the possiblility of hemarthrosis,
effusion, and pain.
Rehabilitation
Early
range of motion and protected weight bearing are an essential
part of the post-operative management. One could expect
to be on one to two crutches for 6-12 weeks though range
of motion and limited weight bearing would begin immediately
post-operatively. Progression of weight bearing would
be made on an individual basis depending on pain, swelling,
and the overall reconstruction.
Conclusion
OATS
is presently the only method to replace defects in hylane
cartilage with hylane cartilage. Osteoarticular tranplantation
has had a good rate of early success, though longer-term
studies are needed to fully evaluate its effectiveness.
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