Cartilage Regeneration

Overview of Cartilage Repair from an Arizona Orthopedic Surgeon

Whether you’re a beloved grandparent or an elite athlete, joint damage affects a large portion of the population. Approximately twelve million individuals visit their doctors, annually, due to some sort of joint pain and or knee discomfort. While each case varies, most knee pains can be attributed to the degradation of the bones articular cartilage.

Articular cartilage consists of a smooth white tissue that envelops the ends of bones where theyKnee pain meet to form a joint. By acting as an impact-cushion, when healthy, this firm rubbery substance supports normal movement within a joint by lubricating the bone segments and assisting in its natural gliding movement.

Whenever articular cartilage begins to deteriorate and or becomes damaged, patients begin to experience limited movement within their knee joint coupled with extraordinary pain. If a patient experiences these symptoms they should schedule a visit with their orthopedic specialist as these symptoms can worsen. Due to the cartilages inability to heal itself, if left untreated many simple cases of cartilage degradation can result in more serious conditions, such as osteoarthritis, that consequently results in more serious procedures such as knee replacements.

Cartilage repair procedures exhibit the most success with osteoarthritis-free knees. Typically candidates are individuals who have:

  • Experienced some sort of injury to the area (sports injuries included)
  • Degraded the cartilage due to sustained periods of strain and wear
  • Inherited hereditary deformations that affect the function of the knee joint

The procedure process usually begins with a magnetic resonance imaging (MRI) screening that allows the doctor to assess the region, severity, and magnitude of the injury. Once observed, your orthopedic specialist can diagnose the severity of the injury and formulate a regimen of treatment options that will successfully alleviate your condition. The most common forms of cartilage restoration procedures are:

 

  • Microfractures: This minimally invasive procedure has cemented itself as the standard treatment option for cartilage injuries within the United States. Using an arthroscope, several small incisions are made above the knee joint- giving the surgeon discrete access to the injured area. Once the degraded area is reached, the surgeon uses an awl to drill small, multiple holes in the joint surface and subchondral bone. By using the body’s natural regenerative processes these small holes trigger a minimal amount of bleeding, stimulating cartilage regeneration and the formation of new cartilage tissue.

 

  • Autologous Chondrocyte Transplantation (ACI): This procedure consists of two-steps in which, first, cartilage cells are removed from one part of the bone, harvested, and then subsequently transferred to the damaged cartilage area. During the first procedure cartilage acicells are removed from a non-weight bearing region of the bone and cultured in a laboratory setting for approximately three to five weeks. Once cultured these cells are then harvested for the second procedure. During the second procedure, the surgeon sews a protective tissue sheath (periosteum) over the affected area and then implants the harvested cells in the damaged region. This procedure proves extremely promising due to its lack of patient induced rejection- as the cells produced to repair the region are from the patient themselves.

 

  • Osteochondral Autograft Transplantation (OATS): This procedure is a bit more in-depth as it requires moving bone grafts from an independent region of the joint to the afflicted area. During this surgery several cone shaped samples of healthy cartilage are removed from non-weight bearing regions of the knee so that they can be transplanted into the damaged area. These “bone-cones” are used as plugs so that the surgeon can successfully resurface the area and provide a new cover for the once damaged area.

While most of these procedures are highly successful, the patients’ treatment options are dependent on your mesa orthopedic specialist and what they deem to be best fit. Once a patient undergoes one of these forms of cartilage repair the recovery period typically lasts several months.

The operated area must be looked after and patients must use crutches for the first several weeks so that weight-bearing strain does not interfere with the rehabilitation process. Many Gilbert orthopedic doctors may recommend physical therapy to aid in the healing process, but as mentioned before it is dependent upon the premise of each individual’s circumstances.

OSPI is the top orthopedic practice in the East Valley treating patients from Mesa, Gilbert, Chandler, Queen Creek, Casa Grande, Maricopa and surrounding areas. Most insurance is accepted, with the Board Certified orthopedic knee specialists offering all types of cartilage restoration procedures. This also includes stem cell procedures!

Call for the best Arizona knee doctors today at (480) 899-4333!

Cartilage Regeneration Options in Gilbert, Chandler, Mesa AZ

What Is Cartilage Regeneration?

 

Back in the year 2014, a study was carried out by researchers from the Hospital for Special Surgery. They discovered that patients who suffer from cartilage damage in their knee can have it treated with good results, due to the revolutionary technology of cartilage re-generation.knee cartilage defect

The research and a few case studies that followed after the discovery were presented to the American Orthopedic Society for Sports Medicine at its annual meeting held in Chicago that year.

Current Approaches to Cartilage Repair

The name of the tough and incredibly flexible tissue which acts as a cushion for bones and joints is Hyaline Cartilage and it’s this that prevents joints and bones from rubbing against each other during physical activity. Gradual wear and tear or trauma can result in the hyaline cartilage being damaged, which in turn, limits normal joint movement and cause patients to suffer through severe pain. This condition, if left untreated for a long time, can lead to disability.

You should know that damage done to the cartilage isn’t as readily repaired by the body naturally, as the cartilage tissue does not having its own blood supply that would have been otherwise used to bathe damaged tissue and promote cartilage regeneration.

Thus, the current approach of surgeons to effectively treat cartilage damage and help promote its growth is by employing a technique called micro-fracture, a surgery which is generally performed on young adults, who as a result of a sports injury, are suffering from a cartilage tear.

While the procedure promises and gives good results to damage on a smaller scale, micro-fracture is ineffective for those who have widespread cartilage de-generation, or osteoarthritis.

Lighting the Way towards Cartilage Regeneration

Attempts have been made over the years by researchers and orthopedic surgeons alike to build human cartilage outside of the body for years and most of the attempts have proved to be successful, largely due to today’s technological advancements.

The process that is widely used to mimic and grow human cartilage outside of the body involves planting a number of cartilage producing cells into a biological scaffold, then placing them into incubation conditions found in the human body.

There are a number of factors concerned with the effective and successful regeneration of cartilage, one of them being the scaffolds that are being used for the experiment according to Jennifer Elisseeff, director of the Cell and Tissue Engineering Program at John Hopkins University. In her own lab, she uses hydrogel which is a specific type of scaffold.

After spending several years working on creating the highest quality cartilage under lab settings, Elisseeff discovered that the quality of the regenerated cartilage can be influenced for the better if a hydrogel scaffold could be used on the patient following micro-fracture surgery. A series of clinical trials followed the discovery, the results of which were published in Science Translational Medicine.

Clinical Trial Results

The results showed that more of the cartilage defect was filled successfully by the repaired cartilage, i.e. in 86% of the patients, after receiving the special gel/adhesive as compared to 64% who didn’t. Moreover, the cartilage implanted closely resembled the native strains in those who underwent the gel/adhesive treatment following a micro-fracture surgery.

OSPI in Arizona offers comprehensive treatment options for cartilage regeneration, including microfracture, Carticel, OATS procedure and stem cell therapy. The Board Certified providers treats patients from the entire East Valley including Chandler, Gilbert, Mesa, Queen Creek, Casa Grande, Maricopa and surrounding areas.

Call today for the top knee, hip and shoulder specialists in Arizona’s East Valley today!

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