How Does Cartilage Repair Itself

Last updated on 16 Oct 2022

Dr Tan Chyn Hong, orthopaedic surgeon at Mount Elizabeth Novena Infirmary, explains the treatments available to repair or regenerate damaged cartilage.

Cartilage is essentially a white shiny textile that helps cushion and encompass the expanse where the bones encounter the joints. It serves every bit a lubricating surface equally well as a shock absorber. Cartilage damage tin can exist seen every bit a hole or crater on the otherwise polish surface of the articulation. If left untreated, the joint tin become stiff, swollen and painful. It may fifty-fifty progress to a stage that requires a total joint replacement with metal and plastic components.

Cartilage regeneration is a procedure that attempts to restore damaged cartilage by harnessing the body'south cells to regrow or supersede lost cartilage.

Most of these treatments can be done past arthroscopy (more commonly known as keyhole surgery), providing benefits of less pain, less bleeding, and faster recovery. Withal, some injuries will still crave a traditional open incision technique where a bigger cut is made to expose the cartilage harm.

While it may non be an easy trouble to treat, here are 6 treatments available to repair or regenerate damaged cartilage.

Talk to a specialist to learn more than nearly your articulatio genus or joint pain and learn which treatments may be suitable for you.

Arthroscopic debridement

For the less severely damaged cartilage, all that is needed is a 'clean upwardly' procedure. During this procedure, a video camera is inserted through a small incision and saline is introduced to wash out the articulation. Washout expels whatever loose droppings. Debridement involves removing the damaged cartilage, and this is often performed concurrently with the washout.

Microfracture

Microfracture is a surgical procedure to treat areas of damaged cartilage. It is done to stimulate the growth of new cartilage in patients with a small surface area of damaged cartilage. The process is often performed inside the knee articulation, but may also exist used to treat other joints such as, the hip, ankle, and shoulder.

For injuries smaller than 2cm^two, microfracture is the recommended procedure. Information technology involves puncturing small-scale holes in the hard interface between the cartilage and the underlying bone to create channels for the bone marrow cells to surface and make full the crater. The minor holes form a blood clot rich in stem cells and eventually remodels into fibrocartilage. Fibrocartilage is a tough, dense and elastic fabric that helps fill in the torn function of the cartilage, hence repairing the lesion.

Autologous chondrocyte implantation (ACI)

ACI is most often recommended for younger patients who take single defects larger than 2cm². This is a 2-pace procedure that takes several weeks to consummate. The offset procedure involves extracting healthy cartilage cells from a non-weight bearing area of the knee through minimally invasive surgery. The cells are so cloned and grown in the laboratory for six – 8 weeks. Thereafter, a surgical procedure is done to implant the newly grown cells into the damaged surface area.

Articular cartilage repair: Matrix-induced autologous chondrocyte implantation (MACI)

This is a 2-step procedure that repairs the articular cartilage harm past using the patient's own cultured cartilage cells. The first step is similar to that in ACI where salubrious cartilage cells are extracted from a non-weight bearing area of the knee. The cells are then cultivated on a membrane. Several weeks afterwards, the membrane is placed into the defect. This helps the cartilage regenerate.

Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. The presence of cartilage in the joints helps in motion and allows basic to glide over each other with little friction. Daily wear and tear or an injury may consequence in impairment to the articular cartilage.

Osteochondral autograft transplantation

In this 1-step procedure, the surgeon harvests a 'plug' of healthy tissue and bone from an unaffected, non-weight begetting area of the patient'due south own joint. The new graft is transferred to supercede the harm expanse. When multiple 'plugs' are used, the result is like a mosaic pattern, hence the term mosaicplasty.

Stem jail cell therapy

Stem cells, or more accurately mesenchymal stalk cells (MSC) have been used in a research setting to repair and regenerate cartilage damage.  MSCs are found in multiple human adult tissues including bone marrow and adipose tissues. They accept the power to differentiate into bone, cartilage, musculus, and adipose tissue. Human clinical trials accept been published showing promising results but long term studies are needed before it can exist utilised routinely in the normal clinical setting.

Post-operative care

Afterwards the cartilage repair procedure, there is usually a menses (6 – 8 weeks) during which the patient is required to use crutches. This is to reduce pressure on the healing cartilage. The time taken for consummate recovery could be up to three – half dozen months.

Consult a specialist about your knee joint or joint hurting and the treatments available.

Article contributed past Dr Tan Chyn Hong, orthopaedic surgeon at Mountain Elizabeth Novena Infirmary

References

Articular Cartilage Restoration (n.d) Retrieved September 21, 2022, from https://orthoinfo.aaos.org/en/treatment/articular-cartilage-restoration

Microfracture Surgery for Cartilage Damage (2020, January xxx) Retrieved September 21, 2022, from https://world wide web.verywellhealth.com/microfracture-2549485

Source: https://www.mountelizabeth.com.sg/healthplus/article/6-treatments-for-cartilage-damage

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