Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery : (315) 251-3100
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Cartilage Regrowth

Articular cartilage is a complex avascular (no blood supply) tissue which consists of cells called chondrocytes suspended in a collagenous matrix. It appears as a smooth, shiny, white tissue at the ends of the bones which come in contact with each other to form a joint. It reduces the friction when the bones glide over each other and makes the movements smooth and enables the joint withstand weight. Alternately, it acts as a shock-absorber.

This cartilage is subjected to the normal wear and tear and may sometimes get damaged because of injury causing pain and impaired function. There are several surgical methods that have been devised to restore the articular cartilage as it does not heal by itself and may even progress to arthritis.

Most of the cartilage restoration procedures are done using an arthroscope. During the procedure, three small puncture incisions are made around your joint. In some procedures, longer incisions may be required to gain access to the affected area. Overall, your recovery after arthroscopic procedure will be faster and less traumatic than open surgery.

The surgical procedures performed for cartilage repair or regrowth include:

Microfracture: This technique stimulates the formation of new articular cartilage by creating blood supply to the joint surface. The procedure is done arthroscopically. Multiple holes are made into the bone (subchondral bone) below the cartilage with a sharp tool called awl. This helps blood supply to reach the damaged cartilage and form new cartilage. Young patients with single lesion and healthy bone are suitable candidates for this procedure.

Drilling: This is an arthroscopic procedure similar to microfracture, in which multiple holes are made in the subchondral bone with the help of a surgical drill or wire. This creates a healing response. The heat produced by the drill may injure the tissues, which is a drawback of this procedure.

Periosteal Grafting: This technique is performed in patients with large areas of cartilage damage in the knee. Periosteal grafts are taken from tissues lining the outer surface of bones in a non weight bearing area of the joint. In this procedure, the damaged cartilage is removed and multiple holes are created in the bone to stimulate bleeding. The periosteal grafts are then attached to the subchondral bone with the help of sutures and glue. The periosteum cells provide growth factors to produce cartilage in the damaged area.

Perichondral Grafting: This technique is similar to periosteal grafting but the graft is harvested from the lower part of the rib along with its chondrogenic layer. The procedure can be performed using minimally invasive technique or open surgery. Once harvested, the perichondral grafts are fixed to the subchondral bone with the help of fibrin glue. This method also helps in regeneration of cartilage in the damaged area.

Osteochondral Autograft or Mosaicplasty: This grafting technique is indicated in patients whose articular cartilage damage is less than 2 cm in diameter. In this procedure, the hyaline cartilage is harvested from a non weight-bearing joint of the same individual (autograft) and transplanted in a mosaic pattern to the damaged area. The cells in the articular cartilage grow in the damaged area to promote healing. This procedure can be carried out arthroscopically or through open surgery.

Articular Cartilage Paste Grafting: It is a minimally invasive, arthroscopic procedure to stimulate regrowth of damaged articular cartilage surfaces. In this technique, multiple holes are created in the bone to induce bleeding. The articular cartilage graft is then harvested from the patient’s intercondylar notch at the center of the knee. The graft is smashed to make a paste which is then inserted into the damaged area. This method helps in re-growth of cartilage and provides better pain relief compared to all other grafting procedures.

After cartilage grafting surgery your doctor will recommend you to wear a knee brace to immobilize the knee joint and promote healing. Physical therapy exercises may be done to strengthen your leg muscles and restore movement to the operated joint.

Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
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Syracuse Orthopedic Specialists American Association of Orthopaedic Surgeons
The American Orthopaedic Society for Sports Medicine
Arthroscopy Association of North America
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