Cartilage regeneration
The ends of the bones in your knee are covered with smooth articular cartilage. It has very limited ability to heal, so a damaged patch can cause pain, swelling and catching and may lead to arthritis over time.
Causes
- Sports injuries and twisting injuries
- Kneecap dislocation
- Osteochondritis dissecans, where a piece of bone and cartilage loosens, often in young people
- Wear, sometimes worsened by poor alignment
Diagnosis
Cartilage damage is assessed with an MRI scan and sometimes arthroscopy. The size, depth and location of the damage and the state of the rest of the knee determine the best treatment.
Treatment options
- Physiotherapy and activity changes for small or less symptomatic areas
- Fixing a loose fragment back in place, where possible
- Bone marrow stimulation: small holes are made in the bone beneath the defect so healing cells form ‘repair tissue’
- Osteochondral grafting: plugs of healthy bone and cartilage are transferred into the defect
- Scaffold techniques for larger defects.
Cartilage surgery is often combined with an osteotomy, ligament reconstruction or kneecap stabilisation, to correct the underlying problem that caused the damage.
Recovery
Repair tissue takes time to mature. Most people need crutches for around 6 weeks and a structured rehabilitation programme, returning to low-impact exercise at 3 to 4 months and to sport at around 9 to 12 months.
Risks
Include infection, blood clots, stiffness, and incomplete filling or breakdown of the repair.
Frequently asked questions
Will my cartilage grow back completely?
No current technique restores normal cartilage perfectly, but they can reduce pain and improve function.
Is it covered by insurance?
Some techniques need insurer approval in advance. My secretary can help with this.
Does Mr Childs offer Autologous Cartilage Implantation (ACI)?
No. But if this is indicated, Mr Childs would be able to refer you to a service that can provide this.