Well-functioning joints are powered to no small degree by healthy cartilage, the tissue that covers the bones to allow for smooth gliding. When you damage this tissue, you face a very difficult problem — cartilage doesn’t regenerate itself easily.
To surmount this hurdle, Dr. Schell of William Schell, MD, offers cartilage restoration procedures that can restore function to the damaged joint and prevent premature arthritis.
Here’s a look at what we can (and cannot) accomplish with cartilage restoration and the different cartilage restoration approaches.
When cartilage restoration is a good option
You might think that cartilage restoration would be a great solution for the more than 32.5 million sufferers of osteoarthritis (OA) in the United States, a condition characterized by a breakdown in cartilage, but this isn’t the case. When you have OA, the damage in your cartilage is too great for restoration, which is designed for more targeted issues.
In most cases, we use cartilage restoration in younger patients who have specific areas of cartilage damage. For example, if you tear a meniscus or a ligament in your knee, you may also damage the cartilage in the area, creating an adhesion in the tissue that leads to pain. This small area of damage can also set you up for premature onset of OA, which will wreak more havoc on your cartilage.
To prevent this, our goal is to restore the cartilage in this small area, either through regrowth or a graft, to prevent much bigger problems down the road.
While we most often use cartilage restoration for the knee joints, we can also restore damaged cartilage in other joints, such as your shoulders, elbows, or ankles.
The different ways we restore cartilage
Cartilage restoration isn’t one procedure, but a description of a number of different techniques that all share the same goal — replacing your damaged cartilage.
Depending upon the location and degree of damage, we choose one of the following cartilage restoration procedures:
Microfracture, drilling, abrabrasion
With these techniques, we remove the damaged cartilage, and then we create holes in the bone underneath to bring blood to the area to stimulate new cartilage growth. We can do this using a small drill, a high-speed burr, or an awl to create the holes in your subchondral bone.
While effective, this technique leads to the creation of fibrocartilage, which isn’t as strong or durable as the hyaline cartilage it’s replacing.
Osteochondral autograft transplantation
Another cartilage restoration technique we use is taking healthy cartilage (and base bone) from a non-weight-bearing area of your joint and transplanting the plug into the damaged area.
If we can’t use bone and cartilage from your own joint, we may need to turn to an allograft procedure in which we use tissues from an outside source.
Regrowing your cartilage
If you’re a candidate, we can remove healthy cartilage from your joint and, using this as a base, regrow more cartilage cells (chondrocytes) in a lab to create a patch. This process is called matrix-induced autologous chondrocyte implantation, and the new cartilage is typically ready within a month, at which point we implant the new cartilage patch.
These are very simple and brief explanations of the many ways we can repair damaged cartilage through restoration. If you’re a good candidate, we’re happy to sit down with you to explore these procedures further.
To get started, please contact our New York City office, which is located on the Upper West Side on Columbus Circle, to schedule a consultation.