Introduction

The rationale behind using carbon fiber as a biomaterial is as follows:

3. The matrix of carbon fiber materials become infiltrated with connective tissue and, ultimately, organized collagen fibers, thus forming a strong “biological composite” material.

In 1987,¹ Minns et al. published a preliminary clinical experience in a new concept of biological resurfacing using carbon fiber implants in the form of pads or rods placed in defects within the knee that elicit a dense organized matrix of fibrous tissue that forms a new biological and functioning articular surface. No evidence of implant fragmentation has been seen since implantation in the 145 knees studied.¹

Carbon fiber arthroplasty appears to be appropriate in the surgical management of ICRS Grades 3 and 4 articular cartilage lesions in the painful knee.^2,^3,^4,⁵

• Carbon fiber rods (Medicarb, Surgicraft, England or Chopin pins, BMI Biomedical Implants GmbH, Hanstedt, N. Germany). The carbon fibers are fabricated from organic fibers such as polyacrylonitrile or rayon. A braided sheath of 12 rows of 9-micron diameter carbon fiber bundles is drawn around a central core of carbon fibers. The continuous braided rod is cut into individual rods of 12.5 mm in length; the average diameter is 3.2 mm. Porosity is about 50% (Fig. 4B-1).

• Carbon fiber pads (Medicarb, Surgicraft, England). The carbon fiber tows can be produced into layered nonwoven pads with a random loosely arranged porous scaffold, the resulting pads being approximately 4 mm thick in discs up to 22 mm in diameter. Porosity is about 85% (Fig. 4B-2).

• Transarthroscopic operative technique—carbon rods. The cartilage lesion area is debrided as described in Chapter 3. A set of instruments for the different procedures is available (Fig. 4B-3).