Cartilage Injury Treatments
In some cases arthroscopy can be used to ‘smooth’ the cartilage. Although new cartilage cannot grow to take its place, scar tissue appears.
It is also possible to transplant some cartilage from an uninjured part of the knee. Another option is to remove some normal cartilage cells, reproduce them in a lab and then later reimplant them into the damaged area so that new cartilage will grow.
Detached Cartilage of Bone in the Knee Joint
If the injury is fairly recent, it is possible to put the piece back in place. More commonly, the loose body may be removed by arthroscopy.
Cartilage Restoration is a procedure where a patient’s knee is resurfaced, realigned and stabilized thereby avoiding a joint replacement. Cartilage restoration is especially effective in patients who are under 50 and active.
Articular cartilage is a firm, smooth and slippery covering on the ends of bones that protects and cushions the bone joint. Injuries to this cartilage can cause pain and swelling. If partially or fully detached injured cartilage can cause mechanical symptoms such as “locking up or “catching.” If various non-operative treatments fail, surgery may be required. One of the surgical options is cartilage restoration.
There are two types of cartilage restoration:
ACI (Autologous Chondrocyte Implantation)
ACI is indicated for larger areas of full thickness cartilage loss, and requires two surgeries. First we arthroscopically harvest normal cartilage cells from one area of the knee not needed. The second surgery is an open surgery where we implant the cartilage cells back into knee to repair the damaged area.The cells in a gel form which solidify when placed in the cartilage defect area within 10 minutes.
Microfracturing is a technique in which arthroscopically multiple small holes are put in the sub chondylar bone so that bone marrow can bring in blood supply and bent the cartilage defect with fibro cartilage.
In order to provide optimum environment for cartilage to heal Visscosupplementation is injecting a solution of hyaluronic acid. It is used in association with Microfracturing.
Cartilage and bone transplants are indicated when the damaged area is very large, if there is failure of one of the other techniques, or if bone is also injured along with the cartilage. This is when cartilage and bone plugs are harvested from either an uninjured non-weight bearing area of the knee, or from a donor (cadaver), and then transplanted to cover the injured area of bone and cartilage.
Cartilage restoration surgery can take 1-4 hours depending on the injury.
Recovery varies but can take 2-3 months before weight-bearing activities can be pursued.