Knee Cartilage Repair

Articular cartilage covers the ends of each bone and allows a smooth, fluid, pain free motion of the knee joint. The cartilage is an extremely important component of a healthy knee and when damaged a patient will suffer from pain and swelling during activities. If the damage progresses, it will eventually lead to a complete loss of cartilage down to the bone, commonly known as osteoarthritis. A chondral defect, or damage to the articular cartilage, may require surgical treatment if a patient has persistent symptoms despite appropriate conservative care.

Cartilage injuries are diagnosed using a history and physical exam. Plain x-rays will be used to assess the amount of cartilage remaining. In most cases an MRI will be used to evaluate the cartilage surfaces and identify a defect. In addition, the alternate structures in the knee such as the meniscus and ligaments are reviewed.

Knee cartilage repair depends on a number of factors including the size, depth and location of the torn knee cartilage, associated knee injuries, patient’s activity level and patient’s age and weight. Some cartilage injuries can be treated non-operatively, but a surgical knee cartilage treatment is commonly needed in cases with a focal cartilage defect.

The most common knee cartilage repair procedures are chondroplasty and Microfracture. Our team of orthopaedic experts at Wake Forest Baptist Health will choose the appropriate treatment based on each patient’s torn knee cartilage injury. Below are some common techniques:

Chondroplasty: During this procedure, your surgeon will trim away the damaged area of cartilage to alleviate the troublesome pain and swelling using an arthroscopic approach. This knee cartilage treatment is typically reserved for patients who do not have full thickness defects, or no bone to bone rubbing.
Microfracture: During this procedure, your surgeon will utilize a small pick to make holes in the defect’s bony surface. The holes allow the flow of marrow and stem cells which form a clot over the defect, eventually leading to a covering of a fibrocartilage layer. This technique is typically reserved for patients who have a full thickness loss of cartilage, or bone to bone rubbing.
OATs: There are two types of OATs procedures- osteochondral autograft transfer and osteonchondral allograft transplantation. An autograft requires tissue to be harvested from the patient while an allograft requires a donor tissue from a tissue bank. In an autograft OATs procedure, small plugs of cartilage and bone are removed from the healthy portion of a patient’s knee and transferred to the damaged area. In an allograft OATs procedure, the cartilage and bone plugs are harvested from a donor and transplanted to the damaged area.
Autologous cartiage implantation (ACI): ACI is a two stage procedure where a biopsy of healthy cartilage is first removed from the knee. Cartilage cells are harvested from the biopsy tissue, expand in a lab, and the replanted in the patients knee during a second surgery to facilitate growth of new cartilage surfaces.

Recovery and Rehabilitation After Articular Cartilage Defects Surgery

Our team will provide a detailed physical therapy program for patients following a knee cartilage treatment. Post-operative management is unique for each patient and depends on the specific knee cartilage repair performed and the severity of the torn knee cartilage.

Patients who underwent chondroplasty are typically instructed to use crutches for a few days and allowed tolerated weight bearing with full range of motion. Patients who underwent Microfracture, ACI or an OATs procedure are placed in a brace and weight bearing is protected for approximately six to eight weeks.

Following surgery, a continuous passive motion (CPM) machine is generally used in these patients for six weeks. Typical time frame for maximum improvement following cartilage replacement is often six to twelve months.

Providers

Insurance

Insurance Accepted

This chart is a list of the most common health insurance plans we accept. This list is subject to change. Please check your individual plan to confirm their participation and the coverage allowed.

Due to the different physician groups and hospitals within the Wake Forest Baptist system, physician services and hospital services are billed separately. Please remember that health insurance coverage varies, so some services may not be covered.

If you don’t see your plan or you have questions, please call our Customer Service Center at 877-938-7497. We will do our best to work with you and your plan.

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC -Not Contracted, very low to no volume for facility and/or CHC

Wake Forest Baptist Health Managed Care/MA Contracts - January2022

AETNA CONNECTED ACA/Exchange: Accepted at all locations

AETNA (PPO & HMO): Accepted at all locations

AETNA MEDICARE: Accepted at all locations

AETNA WHOLE HEALTH: Accepted at all locations

ALIGNMENT HEALTHCARE MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and Wilkes (not applicable to services provided at High Point)

AMBETTER OF NC: Accepted at all locations

AMERIHEALTH CARITAS NEXT ACA/Exchange: Accepted at all locations

APEX MEDICARE ADVANTAGE: Accepted at all locations

BCBSNC (PPO & HMO): Accepted at all locations

BCBS HIGH PERFORMANCE (NATIONAL NETWORK): Accepted at all locations

BLUE LOCAL WITH ATRIUM HEALTH: Accepted at all locations

BLUE MEDICARE: Accepted at all locations

BLUE VALUE: Accepted at all locations

CAROLINA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

CIGNA: Accepted at all locations

CIGNA BEHAVIORAL HEALTH: Accepted at NCBH and High Point (not applicable to services provided at Davie, LMC, CHC and Wilkes)

CIGNA HEALTHSPRING MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and High Point (not applicable to services provided at Wilkes)

CIGNA LIFESOURCE (TRANSPLANTS): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

COVENTRY/WELLPATH: Accepted at all locations

CRESCENT PPO (ASHEVILLE): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

DEVOTED HEALTH: Accepted at all locations

DIRECT NET: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not contracted, very low to no volume for CHC)

FIRST HEALTH (COVENTRY): Accepted at all locations

FIRSTCAROLINACARE (PINEHURST, NC): Accepted at NCBH (not contracted, very low to no volume for WFUHS, Davie, LMC, CHC, Wilkes and High Point)

GATEWAY HEALTH ALLIANCE (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

GOLDEN RULE INS (UNITED): Accepted at all locations

HEALTHGRAM (formerly PRIMARY PHYSICIAN CARE): Accepted at WFUHS, NCBH and LMC (not contracted, very low to no volume for Davie, CHC, Wilkes and High Point)

HEALTHTEAM ADVANTAGE: Accepted at all locations

HUMANA CHOICECARE: Accepted at all locations

HUMANA MEDICARE ADVANTAGE: Accepted at all locations

LIBERTY ADVANTAGE (MEDICARE ADVANTAGE): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

MAGELLAN (BEHAVIORAL HEALTH): Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

MEDCOST: Accepted at all locations

MEDCOST ULTRA: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not applicable at CHC)

OPTUMHEALTH (TRANSPLANTS - APPLICABLE TO NCBH/WFUHS ONLY): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

PREFERRED CARE OF VA INC: Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

SOUTHERN HEALTH SVCS (COVENTRY-PPO ONLY): Accepted at WFUHS, NCBH, Davie and CHC (not contracted, very low to no volume for LMC, Wilkes and High Point)

TWIN COUNTY (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

UNITED BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH, CHC and High Point (not applicable to services provided at Davie, LMC and Wilkes)

UNITED BEHAVIORAL HEALTH INTENSIVE OUTPATIENT PROGRAM (WFUHS ONLY): Accepted at WFUHS (not applicable for services provided at NCBH, Davie, LMC, CHC, Wilkes and High Point)

UNITED HEALTHCARE: Accepted at all locations

UNITED HEALTHCARE ESSENTIALS ACA/EXCHANGE: Accepted at all locations

UNITED HEALTHCARE MEDICARE: Accepted at all locations

VA CCN: Accepted at all locations

WELLCARE: Accepted at all locations

WELLPATH (COVENTRY): Accepted at all locations

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC - Not Contracted, very low to no volume for facility and/or CHC

Referring Physicians

At Atrium Health Wake Forest Baptist we understand the importance of referrals. Our Physician Liaisons partner with referring physicians in our community and beyond to provide information on our physicians and clinical services. Full list of new physicians.

Contact the Physician Liaisons