Does damage to the knee cartilage heal?

Is it true that damage to the knee cartilage doesn’t heal? I think I may have that problem, and I’m wondering what to do.

Small areas of damage to the cartilage in the knee joint have a limited ability to fill in with fibrocartilage. Complete and normal healing is not likely. Areas of full-thickness lesions larger than two centimeters by two centimeters (two centimeters squared) are not likely to heal without treatment.

Treatment today involves several techniques designed to stimulate bone marrow to make a clot. With multiple fibrin clots, a small defect in the cartilage can fill in and replace normal cartilage with similar cartilage.

One of those techniques is called microfracture. Another is autologous chondrocyte implantation (ACI). The microfracture procedure is done in one step. Tiny holes are drilled around and through the cartilage defect. Blood and fat cells from the bone marrow migrate into the area of the lesion and begin a healing process.

ACI is a two-stage operation. Healthy cartilage is harvested from the patient and placed in a special solution. After several hours, the cells are washed and mixed with a small amount of the patient’s blood serum. This is allowed to sit in the lab for several weeks while the cells multiply.

When the cells have increased 20 to 30 times, then the new chondrocytes are injected into the lesion. Special steps are taken to prepare the damaged area first before implantation.

These techniques are fairly new. No long-term studies have been done to show what happens years after the surgery is done. Short- to mid-term studies show good results. Some surgeons prefer the microfracture approach to ACI because of the difference in cost, technical difficulty, and extra surgery of ACI.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Drilling holes in knee joint cartilage to heal lesions

Have you ever heard of drilling holes in the knee joint cartilage to get it to heal? The surgeon who is recommending this treatment says that it is a well-documented approach. Is this so? How does it work?

The technique you are referring to is called microfracture. It is designed to help full-thickness articular cartilage lesions heal. It seems that if left alone, the body doesn’t heal this area fully or completely.

It is both a safe and effective treatment technique. Many studies have been done and reported on. Results seem to depend on choosing the right patients. The lesion must be well-contained and not too large.

Surgical technique is also important. The surgeon uses an arthroscope to work inside the joint. The area is cleaned and smoothed in preparation for the procedure. Any pieces or fragments of cartilage should be removed.

Then special surgical tools called awls are used to make tiny holes into the bone marrow. Tiny drops of blood and fat from the marrow seep into the holes and fill them. This is the start of the healing phase. Before leaving the joint, the surgeon will also take the time to look for any scar tissue or meniscal tears that require repair or removal.

By drilling through the subchondral bone, channels are formed that allow bits of bone marrow to clot in the holes. A network of blood clots form into a scaffold. Capillary vessels then form to supply the area with blood supply. Stem cells from the bone marrow form into new cartilage cells.

The fibrocartilage that forms isn’t the same as natural cartilage. The surface is not as strong and must be protected carefully during healing. The results are usually excellent. Pain relief, restoration of joint motion, and return to full function can be expected.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Does damaged knee cartilage heal?

Is it true that damage to the knee cartilage doesn’t heal? I think I may have that problem, and I’m wondering what to do.

Small areas of damage to the cartilage in the knee joint have a limited ability to fill in with fibrocartilage. Complete and normal healing is not likely. Areas of full-thickness lesions larger than two centimeters by two centimeters (two centimeters squared) are not likely to heal without treatment.

Treatment today involves several techniques designed to stimulate bone marrow to make a clot. With multiple fibrin clots, a small defect in the cartilage can fill in and replace normal cartilage with similar cartilage.

One of those techniques is called microfracture. Another is autologous chondrocyte implantation (ACI). The microfracture procedure is done in one step. Tiny holes are drilled around and through the cartilage defect. Blood and fat cells from the bone marrow migrate into the area of the lesion and begin a healing process.

ACI is a two-stage operation. Healthy cartilage is harvested from the patient and placed in a special solution. After several hours, the cells are washed and mixed with a small amount of the patient’s blood serum. This is allowed to sit in the lab for several weeks while the cells multiply.

When the cells have increased 20 to 30 times, then the new chondrocytes are injected into the lesion. Special steps are taken to prepare the damaged area first before implantation.

These techniques are fairly new. No long-term studies have been done to show what happens years after the surgery is done. Short- to mid-term studies show good results. Some surgeons prefer the microfracture approach to ACI because of the difference in cost, technical difficulty, and extra surgery of ACI.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

If you have femoroacetabular impingement, is it inevitable that arthritis will eventually set into that hip?

Is it always the case that if you have femoroacetabular impingement (which I have) that arthritis will eventually set into that hip?

Not necessarily though many individuals with femoroacetabular impingement (FAI) do indeed eventually develop degenerative changes that lead to arthritis. This is most likely to happen in cases of untreated FAI.Let’s define femoroacetabular impingement and talk about how it can lead to osteoarthritis of the hip joint. Impingement refers to some portion of the soft tissue around the hip socket getting pinched or compressed. Femoroacetabular tells us the impingement is occurring where the femur (thigh bone) meets the acetabulum (hip socket). There are several different types of impingement. They differ slightly depending on what gets pinched and where the impingement occurs.The cam-type of impingement is the most likely to set up conditions ripe for joint wear and tear. This type occurs when the round head of the femur isn’t as round as it should be. It’s more of a pistol grip shape. It’s even referred to as a tilt or pistol grip deformity. The femoral head isn’t round enough on one side (and it’s too round on the other side) to move properly inside the socket.The result is a shearing force on the labrum and the articular cartilage, which is located next to the labrum. The labrum is a dense ring of fibrocartilage firmly attached around the acetabulum (socket). It provides depth and stability to the hip socket. The articular cartilage is the protective covering over the hip joint surface. This abnormal contact between the femur and acetabulum is the leading cause of labral tears and degenerative hip arthritis.Treatment is advised when impingement is painful, limits function, and/or X-rays show potential for joint changes. You may be able to follow a conservative path by modifying activities and carrying out a program of strengthening and stretching exercises. In some cases, surgery is indicated to correct the problem.No one knows for sure who will develop arthritis. Studies are underway to determine how common is the problem and what factors might increase the likelihood of developing arthritis. Your orthopedic surgeon will follow your case and advise you if and when treatment (and what treatment) is appropriate.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Soccer player tore knee cartilage, wants to skip some rehab!

I’m 23-years old. I tore my knee cartilage clear down to the bone in a soccer match. The surgeon tells me I’ll be on a machine to make my knee move for six weeks after an operation to repair the damage. I don’t have that kind of time for rehab. Is there any way around this restriction?

Right now the standard rehab after microfracture for full-thickness cartilage tears is to avoid weight-bearing and use continuous passive motion (CPM). CPM uses a device to slowly move the knee through its range of motion. It’s usually used for six to eight hours a day for up to eight weeks after microfracture.

Microfracture is one way to enhance healing. Tiny holes are made in the bone just beneath the cartilage. Fibrocartilage fills in where the cartilage is torn and pulled away from the bone.

Researchers are calling the standard rehab procedure into question. Studies show no difference in results with or without the use of CPM. Likewise, putting weight on the leg isn’t a problem either. Up until now the theory was that pressure through the joint would disrupt the healing process.

Ask your doctor to review the latest studies on this rehab method. With close supervision you may be able to bypass the six weeks’ restriction and return to sports sooner.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.