The knee joint is an intricate arrangement of bones, cartilage, and other soft-tissue structures. The articulating surfaces of the femur (thigh bone), tibia (shin bone), and patella (kneecap) are enveloped in a slippery and shiny white connective tissue known as articular cartilage. The primary responsibility of the articular cartilage is to reduce friction with joint movement allowing for these bones to painlessly glide over one another. This tough connective tissue also provides a protective barrier for the bones. A traumatic injury or the natural aging process can result in damage to the articular cartilage. If left untreated or not corrected appropriately, an articular cartilage injury can develop into a painful osteoarthritic condition from bone-on-bone joint movement.
Patients with smaller focal articular cartilage lesions may benefit from conservative treatment measures alone. These can include rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs). Surgical intervention may be necessary when patients fail to respond to initial conservative therapies or have more significant damage to the articular cartilage. There are a number of approaches that can be utilized to surgically repair articular cartilage injuries. Surgical intervention is likely to be more beneficial for patients with singular cartilage defects than for patients with multiple cartilage lesions. Dr. Frank McCormick, orthopedic knee doctor, treats patients in Orlando, Palm Beach County, and surrounding Florida communities, who have experienced an articular cartilage injury and are in need of surgical restoration.
Articular cartilage repair and restoration can be accomplished through a number of surgical techniques that are tailored to the patient’s specific cartilage defects. These highly patient-specific procedures should therefore only be completed by an orthopedic knee doctor with extensive knowledge and training in these restorative techniques. Dr. McCormick will review several patient factors to determine which of the following surgical approaches is best for articular cartilage repair and restoration:
Also known as debridement, this simple surgical technique uses a small camera (arthroscope) and specialized surgical instruments to excise and remove any damaged cartilage fragments. Any other tissue irregularities, such as loose bodies or inflamed tissues, noted on prior examination are also excised and removed to prevent additional joint irritation. Patients with full-thickness cartilage lesions are not considered ideal candidates for this surgical approach.
This surgical treatment method consists of two stages. A minimally invasive arthroscopic procedure is used in the first stage to collect healthy cartilage cells directly from the patient. This collection of cells is transferred to a tissue culture lab where they are cultivated and multiplied into a tissue sheath. When this sheath has grown to the desired size, it is then integrated into the patient’s cartilage defect in a second minimally invasive procedure.
In recent years, alternative therapy options have been developed that integrate biologic compounds created using platelets or stem cells harvested from the patient. Platelets are pieces of large bone marrow cells that can be extracted and concentrated into platelet-rich plasma (PRP). This solution is delivered to the injury site with the goal of minimizing inflammation and stimulating the development of new fibrocartilage. Stem cells are typically harvested from the hip and suspended in a compound known as Bone Marrow Aspirate Concentrate (BMAC). This suspension is also infused into the injury site to generate new cartilage growth.
The recovery from articular cartilage repair and restoration is determined by the specific surgical technique conducted by Dr. McCormick. While a chondroplasty procedure generally yields a full recovery in approximately 6 weeks, the autologous chondrocyte implantation (ACI) procedure typically involves a 3 to 4 month recovery period. No matter the surgical approach performed, the majority of patients in Orlando, Palm Beach County, and the surrounding Florida communities can expect the following during the recovery process:
For more information on articular cartilage restoration, or to discuss your articular cartilage injury treatment options, please contact the office of Frank McCormick, MD, orthopedic knee doctor serving Orlando, Palm Beach County, and surrounding Florida communities.
