Cartilage Defects

FAQ’s on Cartilage Defect Treatment in Oklahoma

 

Articular cartilage restoration is an important part of orthopedic medicine. The general population is aging, and people are living longer. Articular cartilage wear-and-tear is more common among older persons, which means cartilage defects are increasing.

 

What is the purpose of articular cartilage?

 

Articular cartilage allows the knee to tolerate large forces and absorb shock. The knee joint alone can carry loads up to 20 times the body’s overall weight. The ends of bones are typically covered with articular cartilage, which is an elastic, tough material that allows the joint to move smoothly.

 

The inability for articular cartilage to regenerate contributes to these defects. Articular cartilage integrity is important to preserving joint function. Cartilage is formed from chondrocytes, which are less prevalent with injury and age.

 

What are the signs of articular cartilage injury?

 

Regarding the knee, cartilage injury typically causes pain, which is worsened when walking down hills, descending stairs, or climbing stairs. Knee cartilage defect often occurs in athletic people who are runners, cyclists, soccer players, or skiers.

 

What causes an articular cartilage injury?

 

Articular injury can occur in young adults from overuse, injury, muscle weakness, or misalignment. Instead of gliding smoothly across bone ends, the knee cap may rub against it, which can roughen or damage the cartilage underneath.

 

How common is articular knee cartilage injuries?

 

In a case series study, researchers found that 95% of articular cartilage injuries affected the patellofemoral joint (knee). The cartilage defect was caused by chondral or osteochondral fracture, and associated with patellar cracks.

 

How many cartilage-related injuries occur each year?

 

In the U.S., more than 500,000 procedures are performed due to cartilage-related injuries. Cartilage defects are noted in around 65% of routine knee arthroscopies.

 

What causes articular cartilage damage?

 

Defects and damage to the cartilage occurs from both acute ad repetitive trauma, which results in knee pain, mechanical symptoms, and mild effusion. Joint surface defects are common, and they can lead to pain and arthritis.

 

How are cartilage defects treated?

 

  • Surgery – Total joint replacement can be done when the cartilage is damaged severely or wasted away.

 

  • Microfracture – Young active people who are not candidates for a replacement procedure often have microfracturing. This involves drilling holes into the bone surface with a special device. The bleeding and scarring with fibrocartilage replaces the lost cartilage.

 

  • Stem cell therapy – Mesenchymal stem cells (MSCs) have emerged as a treatment option for chondral defects and early osteoarthritis stages. In systematic review of several studies, researchers found 600 clinical studies where stem cells were used to treat cartilage defects. Many of these studies show a significant clinical benefit when stem cells were used.

 

  • Autologous stem cell implantation – Some stem cells are cultured in the laboratory and expanded. These cells are then transplanted to the cartilage defect via arthroscopic means. The goal of stem cell transplantation is to allow patients to return to previous level of function, return to work, regain mobility, and alleviate pain.

 

What can I expect after a stem cell procedure?

 

Depending on the site of the arthroscopic procedure, the joint is braced for several hours. Passive motion therapy starts soon after the procedure, which helps prevent joint stiffness and adhesions. The doctor will refer you to physical therapy to restore knee motion.

 

Resources

  • Aroen A, Loken S, Heir S, et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. American Journal of Sports Medicine. 2004;32(1):211–215.
  • Filardo G, Perdisa F, Roffi A, et al. (2016). Stem cells in articular cartilage regeneration. Journ of Orthoped Surg, 11(42).
  • Nomura E, Inoue M, & Kurimura M (2003). Chondral and osteochondral injuries associated with acute patellar dislocation. Science Direct, 19(7), 717-721.
  • Shah MR, Kaplan KM, Meislin RJ, Bosco JA. Articular cartilage restoration of the knee. Bulletin of the NYU Hospital for Joint Diseases. 2007;65(1):51–60.

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