What is Cartilage Restoration?
Cartilage Restoration is an innovative surgical procedure that regenerates, repairs, or restores damaged joint cartilage. It is an alternative to surgical joint replacement and aims to repair and restore the cartilage so that joint replacement surgery can be avoided.
Cartilage is a flexible yet firm white tissue that covers the surfaces of bones where they come together to form a joint. Cartilage makes the surface of the bones smooth so that they can move against each other smoothly. However, the cartilage can get damaged by wear and tear or through a trauma.
Athletes who make repetitive use of their joints are prone to wear and tear of articulating cartilage. Similarly, individuals who have arthritis also experience cartilage damage.
In most cases, cartilage damage is irreversible and requires life-long care. In extreme cases, cartilage damage can hinder movement and cause intense pain. A person may become temporarily disabled because they cannot utilize the full movement of their body because of the pain from cartilage damage.
Cartilage Restoration is an effective treatment that overcomes these challenges. It aims to:
- Reduce and alleviate pain and other symptoms of cartilage damage.
- Stimulate the growth of new cartilage.
- Delay and prevent the onset of arthritis.
Who Needs Cartilage Restoration?
The eligibility of a patient for Cartilage Restoration procedure is determined after considering the following factors:
- The patient is suffering from articulating cartilage damage in the knee, ankle, or shoulder.
- The patient has tried non-invasive treatments for cartilage damage. Non-invasive treatments have failed to restrain the damage, and there is a threat that the entire cartilage will be affected.
- The patient is less than 50 years of age.
- The patient has an active lifestyle.
- The patient has a single injury or lesion in the articulating cartilage. A single injury means that cartilage damage is focused on one area, not the entire cartilage.
- Patients who have chronic conditions like bone-on-bone osteoarthritis are not eligible for the condition.
How is Cartilage Restoration Performed?
Cartilage Restoration is of two types:
- Autologous Chondrocyte Implantation
- Osteochondral Transplant
Autologous Chondrocyte Implantation (ACI) for Cartilage Restoration
The ACI cartilage restoration surgery is an innovative and relatively new two-step process that targets cartilage damage of full-thickness (down to the bone) over a large area. This cartilage restoration procedure requires two surgeries:
- Arthroscopic surgery to harvest healthy cartilage tissue.
- Open surgery to implant the healthy tissue in the damaged area.
The first surgery is performed arthroscopically to harvest healthy cartilage tissues from an area of the knee, which is not essential to the primary functions of the knee. The arthroscopic procedure is performed under general anesthesia. The surgeon harvests a small piece of the cartilage, around 2-3 cm.
The harvested tissue is sent to the laboratory where it is treated enzymatically to isolate the cells which produce cartilage (chondrocytes). Once the cells are isolated, they are artificially expanded in the laboratory and sent back to the surgeon. This process can take 6-8 weeks.
Once the surgeon receives the expanded chondrocytes, the second step of the cartilage restoration surgery is scheduled. An anesthesiologist administers general anesthesia to the patient. The surgeon sews a special patch or watertight membrane over the damaged cartilage in the joint.
The surgeon injects the harvested healthy cells of the cartilage into the damaged area, where they adhere to the bone and the existing cartilage to form hyaline-like cartilage.
The cartilage producing cells start making new cartilage in the joint, which functions as the native cartilage. It provides cushioning to the bones where they meet each other to form a joint. It allows them to glide over each other smoothly, reducing pain and discomfort and increase movement.
After the ACI Cartilage Restoration surgery, a patient must limit their movement for at least eight weeks. The surgeon will recommend the following steps for a speedy recovery:
- Physical therapy to restore strength and range of motion.
- Continuous Passive Motion (CPM) machine to improve the probability of the graft’s success.
- Start light exercises six months after the surgery,
- Return to full sporting activity or strenuous movements after 9-12 months of surgery.
Osteochondral Transplant for Cartilage Restoration
An Osteochondral Transplant is another method of cartilage restoration surgery in which a plug of bone with overlying articular cartilage are grafted to replace damaged cartilage and bone.
A surgeon recommends the Osteochondral Transplant cartilage restoration surgery when all other procedures have failed, or the damage is too severe to be healed by other procedures.
Osteochondral Transplant cartilage restoration procedure also has two steps: harvesting healthy bone with cartilage and implanting the graft in the damaged area.
The surgeon may procure a healthy bone plug with healthy cartilage from the patient, such a part of articular cartilage and bone, which bears no or minimal weight. The surgeon may also harvest the bone from a cadaver or a donor.
After the harvest, an open surgical procedure is performed to remove the damaged bone and cartilage and replace it with the healthy bone and cartilage. The implant is adhered to the existing joint bone using the press-fit technique.
If the graft is successful, the implanted bone piece will join with the existing bone. Weight-bearing activities are restricted for 6-8 eight weeks after the surgery to give the graft the maximum chance of merging with the existing bone successfully.
The Osteochondral Transplant for Cartilage Restoration restores the hyaline articular cartilage of joints. It alleviates pain and swelling associated with damaged articular cartilage and returns the normal function of joints.
At CMW, you will receive:
- A careful examination and diagnosis.
- Empathetic patient care.
- Attentive staff.
- Qualified surgeons.
- State of the art facility.
- Observant post-op care.
To move is to live. Restore your ability to move today.
Schedule an online consultation with our orthopedic specialist and avail effective, reliable, and best orthopedic treatments in NJ.
Can Knee Cartilage Be Restored?
- Damage to knee cartilage due to injury does not heal on its own.
- There are several surgical techniques that repair, replace, or regenerate the cartilage.
- These surgeries can be performed on any joint, but are most commonly performed on the knee joint.
How Long Does It Take for Knee Cartilage to Heal?
- If the tear is small, it may heal on itself in about six weeks of time if you are young and healthy.
- You may be advised to pursue sports therapy, which focuses on strengthening the supporting structures of the knee like the hamstring and quadriceps muscles.
Will Walking on a Torn Meniscus Make It Worse?
- It is usually painful to walk with a torn-meniscus; the pain gets worse when you twist or squat.
- If your knee is not locked by the torn meniscus, you can walk, sit and sleep with little pain.
Is Cartilage Damage Painful?
- When you damage your knee cartilage – the area becomes warmer from other parts of the body, swells, becomes sore, tender, and painful.
- As the damage to the cartilage progresses, so does stiffness and limited range of motion increases. Your leg will not move so freely and easily as it used to.