Cartilage Restoration: Bringing Relief To Injured Joints

Moving Ahead     Winter 2020
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When you jam or twist your knee hiking, running, playing sports, working around the house, or in some other way – you know it. First, there’s the sudden pain followed by swelling, in many cases.

Often, in an injury like this, a piece of cartilage breaks off in the joint, says Eric Fester, MD, of Premier Orthopedics.

When it’s healthy and intact, cartilage – a smooth, white tissue covering the ends of bones – helps joints move with little friction. Damaged cartilage, though, makes joint movement difficult and painful.

A variety of cartilage restoration procedures are available to repair the damage and restore joint function, says Dr. Fester. These procedures can prevent or delay further wearing away of the cartilage, which can lead to arthritis as bone rubs against bone, eventually requiring joint replacement surgery.

The knee is the most common joint for cartilage restoration, though other joints can benefit from the procedures. In all cases, cartilage restoration is used to repair focal – or localized – cartilage damage, as opposed to the widespread erosion of cartilage that is common with arthritis.

Advanced Cartilage Restoration Treatment Option

Premier Orthopedics offers an advanced cartilage restoration technique, matrix-induced autologous chondrocyte implantation (MACI) cartilage transplant. MACI cartilage transplant, a two-step procedure using the patient’s own cartilage, is most effective for active patients, from their teens to 50s.

In the first stage of a MACI procedure, a small piece of healthy cartilage tissue is removed from a non-weight-bearing area of your knee joint, through a small arthroscopic incision. In a lab, this tissue grows on a membrane into a larger piece of cartilage.

In the second procedure, the cartilage-bearing membrane is transplanted into the damaged area of your cartilage through an open incision. The healthy cartilage cells grow to repair the damage.

Range of Cartilage Restoration Treatments

If the MACI cartilage transplant isn’t right for you, Premier Orthopedics offers a range of other cartilage restoration treatments. Our specialists are board-certified orthopedic physicians and surgeons who are trained and experienced in cartilage restoration procedures – and in determining which procedure is best for your unique needs.

Non-surgical Treatment

  • Physical therapy to help you regain joint function and strength for work and everyday activity
  • Sports medicine to help you return to the game after an injury sidelines you
  • Platelet rich plasma (PRP) injections. These injections use your own platelets to help your body heal itself and return to a healthier, pre-injury state
  • Stem cell therapy to help your body heal damage and relieve pain from arthritis, aging, and injury

Surgical Treatment

  • Cartilage transplant procedures:
    • MACI cartilage transplants, a transplant using the patient’s own cartilage
    • DeNovo technique, a transplant using donor cartilage, instead of your own cartilage
  • Microfracture, in which tiny holes are drilled in the bone, at the base of the cartilage damage, enabling bone marrow cells, or stem cells, to bleed through to form a clot that turns into new cartilage
  • Abrasion arthroplasty, in which a high-speed burr removes damaged cartilage, which, like microfracture, stimulates growth of new cartilage
  • Realignment surgery, or osteotomy, in which a surgeon removes or adds a wedge of bone near a damaged joint to shift weight from the area of damaged cartilage

Besides restoring joint function and relieving pain, cartilage restoration treatment can help prevent further damage to cartilage, which can lead to osteoarthritis and the need for joint replacement surgery.

Risks of Cartilage Restoration

“The biggest risk of cartilage restoration is that it doesn’t work – that the implantation doesn’t ‘take’ or heal and then the lesion gets larger and the patient develops an arthritic joint (requiring joint replacement),” Dr. Fester says.

Other risks include infection, blood clots, and joint stiffness.

“The larger the lesion, the older the patient, the higher chance the procedure won’t work.” Dr. Fester says, “I have a heart-to-heart with the patient and go over the benefits, the risks, what are the chances that it will work, what are the chances it won’t.”

When considering cartilage restoration, Dr. Fester advises patients to look for an orthopedic surgeon who is fellowship-trained or specially trained in sports medicine and experienced in the full range of cartilage restoration procedures.

“It’s not cookie cutter. It’s a matter of picking the right procedure for the right patient so they get the right outcome.”

For more information about cartilage restoration, talk with your primary care doctor or visit our website to make an appointment with one of our specialists.