The articular cartilage refers to the smooth tissue which covers your bones’ ends at the point where they form a joint. Healthy cartilage will make it easy and pain-free for your joints to move as it allows the gliding of your bones with minimal friction.
Your articular cartilage can become damaged as a normal process of wear and tear with the continued use of your joints. Unfortunately, the cartilage will not heal well without secondary intervention, but now, there are surgical techniques used for the restoration of damaged cartilage.
Most patients treated by orthopedic surgeons in Provo, Utah are young ones with a single lesion or injury. In older adults, the surgical procedures used for cartilage restoration are generally bilateral. The commonly affected joints are the knee and shoulder joints. The following are the standard procedures currently used for cartilage restoration:
Microfracture
In this procedure, the damaged cartilage will be removed, and an awl is used to create holes in your subchondral bone. The goal of the microfracture procedure is the stimulation of new articular cartilage growth through the creation of new blood supply which supplies new bone cells for the formation of cartilage.
At times, microfracture is done using an arthroscope rather than an open surgery. Also, this is generally used in young patients with healthy subchondral bone and single lesions. Drilling resembles the microfracture technique but is less precise than the latter, and the heat used in the procedure might damage the surrounding joint tissues.
Autologous Chondrocyte Implantation (ACI)
Here, an arthroscopic procedure is used to remove healthy cartilage cells called chondrocytes from a healthy, non-weight bearing part of your body. These cells are then cultured for three to four weeks in a lab. You will then have an open surgery where bone-lining tissue is sewn over the damaged area and sealed using fibrin glue.
The cultured chondrocytes will be injected into the sewn layer. ACI is used for young patients with single bone defects with diameters of more than 2cm and has no risk of rejection since the cells are the ones used for the implantation.
Osteochondral Autograft Transplantation
Here, the cartilage will be transferred from one part of your healthy, non-weight joint to a damaged area. The harvest includes cartilage subchondral cartilage and a cylindrical cartilage plug which leaves the harvested area with a smooth cartilage surface. Osteochondral autograft transplantation is used for small cartilage defects since only so much healthy cartilage can be harvested from an undamaged joint.
Tissue Engineering
In this relatively new procedure, factors which stimulate the growth of new cartilage are injected into the damaged cartilage area. The growth factors used in tissue engineering will stimulate the growth of healthy cartilage. There is currently ongoing research about using mesenchymal stem cells rather than growth factors for cartilage regeneration.
After your cartilage regeneration, your joint will be protected to ensure the optimal healing of the cartilage. It is necessary not to put any weight on the affected area for some time and walk around with crutches. You will also need physiotherapy to regain the range of motion in your knee or shoulder after the surgical area has sufficiently healed.
