Regenerative Knee Surgery and Blood Testing

The five key steps involved in your treatment process, from diagnosis to recovery.

Step 1: Diagnosis

• The process begins with the identification of cartilage damage in your knee.
• Your surgeon will have discussed the problem and treatment options with you during an outpatient appointment.
• If you decide to proceed with Autologous Chondrocyte Implantation (ACI), you will be asked to complete two consent forms; one for the procedure and one that is specific to the implantation (ACI) procedure.

Step 2: Stage 1 - Biopsy and Blood Testing

Before surgery

• You will receive a letter with the first operation date and admission details.
• You will be asked to attend the Pre-Operative Assessment Clinic to ensure that you are fit and well for your surgery. This may be on the same date as your outpatient appointment or may be at a later date. You may also have blood samples taken at this time.

On the day of surgery

• You’ll be admitted to the hospital, where a patient identification wristband will be placed on you.
• Baseline observations will be taken (blood pressure, heart rate, temperature etc.). As part of your admission assessment, you will be asked questions about your general health and wellbeing. Further blood tests may be required at this point.
• Clinical staff will confirm your consent for the procedure and answer any questions you may have.

In Theatres

• You will be taken into the anaesthetic room where further safety questions will be asked.
• Blood will be collected and tested for the following:
  • HTLV 1 & 11 - these are retroviruses (primarily involves detecting antibodies to the viruses in blood samples) that can affect the immune system. These bloods are tested locally.
  • HIV (Human Immunodeficiency Virus), Hepatitis B, Hepatitis C and Syphilis. These bloods are sent to the laboratory in Germany along with your cartilage tissue for testing.
  • From the 240mls of blood that has been taken, the plasma will be extracted and cells will be grown within it.
• If your blood tests show that you have any of these conditions, you may not be suitable to have the second stage of the procedure. Your consultant will contact you to discuss these results with you if necessary. At this point the laboratory cell growth will be halted. Your consultant will organise for you to come back to clinic to discuss this with you.
• You will undergo a general anaesthetic for this procedure, where you will be asleep (your anaesthetist will have discussed this with you preoperatively).
• The biopsy will be performed using keyhole surgery. Healthy cartilage tissue will be taken and sent to the laboratories in Germany ready for step 3.

After surgery

• You will wake up following your procedure and be monitored whilst you recover from the general anaesthetic. Pain relief will be provided if required to ensure you remain comfortable. After routine observation you will be discharged home. 

Step 3: Laboratory Cell Growth

• In the Spherox Laboratory, your cartilage tissue is processed to create small grains of cartilage material called Spheroids. This process takes approximately 6 to 8 weeks (depending on the growth of the cells). 
• Once an adequate number of Spheroids have been grown, they will later be implanted into your knee. The Spheroids are completely derived from your own tissues and are free of any animal derivatives.

Step 4: Stage 2 - Implantation of Spheroids

Before surgery

• You’ll receive another admission letter with details of the second operation.
• This stage involves implanting the lab-grown cartilage (Spheroids) back into your knee.

On the day of surgery

• The admission process will be the same as for your initial admission, including wristband placement, baseline checks, and consent confirmation.

In Theatres

• The Spheroids will be implanted into the damaged cartilage whilst you are under anaesthetic. Any associated surgery you may require will also be performed at this stage.

After surgery

• You will wake up following your procedure and be monitored whilst you recover from the general anaesthetic. Pain relief will be provided if required to ensure you remain comfortable. Your knee will be in a splint and will be immobilised for 24-48 hours. Your surgeon will visit you on the ward following your procedure and explain everything to you.
• You may be required to stay in hospital overnight. An individualised physiotherapy program will be discussed with you by your surgeon and Physiotherapist.

Step 5: Recovery and follow-up

• The most common side effects following the procedure are pain and swelling in the joint, these symptoms are usually mild and resolve during the weeks following surgery.
• If you experience any of the following side effects, you must contact a doctor immediately for a review –
  • Severe skin reactions,
  • Low blood pressure,
  • Sickness,
  • Dizziness,
  • Fainting,
  • Fever
• There is also a risk of developing a blood clot following the procedure, you will be provided with a separate information leaflet outlining the signs and symptoms to be aware of.
• Recovery time varies for each person. It is important to discuss realistic targets for your recovery with your surgeon.
• Following your individualised rehabilitation schedule is crucial to optimising recovery.

Contact information

If you need any further information, please contact:

Your surgeon's secretary

The contact number will be detailed on your admission or clinic letter.

Physiotherapist

Based at College Green Health and Wellbeing Centre, 0121 728 9442 / This email address is being protected from spambots. You need JavaScript enabled to view it.