Can Damaged Cartilage Repair Itself

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Because cartilage does not heal itself well, doctors accept adult surgical techniques to stimulate the growth of new cartilage. Restoring articular cartilage can salve pain and allow meliorate function.

Articular Cartilage Restoration

Articular cartilage is the smoothen, white tissue that covers the ends of bones where they come together to form joints. Good for you cartilage in our joints makes it easier to move. It allows the bones to glide over each other with very little friction.

Articular cartilage can be damaged past injury or normal wear and tear. Because cartilage does not heal itself well, doctors accept developed surgical techniques to stimulate the growth of new cartilage. Restoring articular cartilage tin salve pain and allow better function. Virtually chiefly, it can delay or forestall the onset of arthritis.

Surgical techniques to repair damaged cartilage are still evolving. It is hoped that as more is learned about cartilage and the healing response, surgeons volition exist better able to restore an injured joint.

Hyaline Cartilage

The main component of the joint surface is a special tissue chosen hyaline cartilage.When information technology is damaged, the articulation surface may no longer be shine. Moving bones along a tough, damaged joint surface is hard and causes hurting. Damaged cartilage can also lead to arthritis in the joint.

The goal of cartilage restoration procedures is to stimulate new hyaline cartilage growth.

Identifying Cartilage Damage

In many cases, patients who have articulation injuries, such equally meniscal or ligament tears, will also have cartilage harm. This harm may exist hard to diagnose because hyaline cartilage does not contain calcium and cannot be seen on an X-ray.

If other injuries be with cartilage damage, doctors will address all bug during surgery.

About candidates for articular cartilage restoration are young adults with a single injury, or lesion. Older patients, or those with many lesions in one joint, are less likely to benefit from the surgery.

The articulatio genus is the most common area for cartilage restoration. Talocrural joint and shoulder problems may as well be treated.

Many procedures to restore articular cartilage are washed arthroscopically. During arthroscopy, your surgeon makes 3 pocket-sized, puncture incisions around your joint using an arthroscope.

Some procedures crave the surgeon to take more straight access to the affected area. Longer, open up incisions are required. Sometimes it is necessary to address other problems in the joint, such as meniscal or ligament tears, when cartilage surgery is done.

In general, recovery from an arthroscopic procedure is quicker and less painful than a traditional, open up surgery. Your physician volition discuss the options with you to determine what kind of procedure is correct for you.

The most common procedures for cartilage restoration are:

Microfracture
Drilling
Chafe Arthroplasty
Autologous Chondrocyte Implantation
Osteochondral Autograft Transplantation
Osteochondral Allograft Transplantation

Microfracture

The goal of microfracture is to stimulate the growth of new articular cartilage past creating a new blood supply. A sharp tool called an awl is used to make multiple holes in the articulation surface. The holes are fabricated in the bone below the cartilage, called subchondral bone. This action creates a healing response. New blood supply tin reach the joint surface, bringing with it new cells that will form the new cartilage.

The goal of microfracture is to stimulate the growth of new cartilage past creating a new claret supply.

A sharp tool called an awl is used to make multiple holes in the joint surface. The holes are made in the bone beneath the cartilage, called subchondral bone. This creates a healing response. New blood supply can attain the joint surface. This will bring new cells that will form cartilage.

Steps of the microfracture technique.(Left) Damaged cartilage is removed.(Middle) Awl is used to make holes in the subchondral bone.(Right) Healing response brings new, healthy cartilage cells.Reproduced from Mithoefer One thousand, Williams RJ III, Warren RF, et al: Chondral resurfacing of articular cartilage defects in the knee with the microfracture technique. J Bone Articulation Surg Am 2006;88(suppl ane):294-304.

Microfracture tin be done with an arthroscope. The best candidates are young patients with single lesions and good for you subchondral bone.

Normal healthy articular cartilage in the genu (left). A big cartilage defect in the genu joint surface (centre). During microfracture, an awl is used to penetrate the defect (right).

Drilling

Drilling, like microfracture, stimulates the product of healthy cartilage. Multiple holes are made through the injured area in the subchondral bone with a surgical drill or wire. The subchondral bone is penetrated to create a healing response.

Drilling tin can be washed with an arthroscope. Information technology is less precise than microfracture and the estrus of the drill may cause injury to some of the tissues.

Abrasion Arthroplasty

Abrasion arthroplasty is similar to drilling. Instead of drills or wires, high speed burrs are used to remove the damaged cartilage and reach the subchondral bone. Chafe arthroplasty can be done with an arthroscope.

Autologous Chondrocyte Implantation (ACI)

ACI is a 2-step process. New cartilage cells are grown and so implanted in the cartilage defect.

Get-go, good for you cartilage tissue is removed from a non-weightbearing area of the os. This step is done as an arthroscopic procedure. The tissue which contains salubrious cartilage cells, or chondrocytes, is and then sent to the laboratory. The cells are cultured and increase in number over a three- to 5-week period.

An open surgical process, or arthrotomy, is then washed to implant the newly grown cells. The cartilage defect is prepared. A layer of bone-lining tissue, called periosteum, is sewn over the area. This cover is sealed with fibrin gum. The newly grown cells are then injected into the defect under the periosteal cover.

ACI is virtually useful for younger patients who have single defects larger than 2 cm in diameter. ACI has the advantage of using the patient's own cells, so there is no danger of a patient rejecting the tissue. Information technology does have the disadvantage of being a two-stage procedure that requires an open up incision. It besides takes several weeks to complete.

Osteochondral Autograft Transplantation

In osteochondral autograft transplantation, cartilage is transferred from i office of the joint to another. Healthy cartilage tissue — a graft — is taken from an area of the bone that does not comport weight (non-weightbearing). The graft is taken as a cylindrical plug of cartilage and subchondral bone. It is then matched to the surface area of the defect and impacted into place. This leaves a smooth cartilage surface in the joint.

A single plug of cartilage may be taken or a process using multiple plugs, called mosaicplasty, may exist performed. A single plug of cartilage may be transferred or a process with multiple plugs, called mosaicplasty, may be done.

Mosaicplasty type osteochondral autograft transplantation procedure. Reproduced from Hangody L, Rathonyi GK, Duska Z, et al: Autologous Osteochondral Mosaicplasty. Surgical Technique J Bone Articulation Surg Am 2004;86 (suppl 1):65-72.

Osteochondral autograft is used for smaller cartilage defects. This is because the healthy graft tissue can only be taken from a express area of the aforementioned joint. It tin can be done with an arthroscope.

Osteochondral Allograft Transplantation

If a cartilage defect is too large for an autograft, an allograft may exist considered. An allograft is a tissue graft taken from a cadaver donor. Like an autograft, it is a block of cartilage and bone. In the laboratory it is sterilized and prepared. It is tested for any possible disease transmission.

An allograft is typically larger than an autograft. Information technology can be shaped to fit the exact contour of the defect so press fit into place. Allografts are typically done through an open incision.

Stem Cells and Tissue Engineering

Current research focuses on new means to make the body grow healthy cartilage tissue. This is chosen tissue applied science. Growth factors that stimulate new tissue may exist isolated and used to induce new cartilage formation.

The apply of mesenchymal stem cells is as well beingness investigated. Mesenchymal stem cells are basic human cells obtained from living human tissue, such as os marrow. When stem cells are placed in a specific environment, they can give ascension to cells that are similar to the host tissue.

The hope is that stem cells placed near a damaged articulation surface will stimulate hyaline cartilage growth. Tissue engineering procedures are nonetheless at an experimental stage. Most tissue engineering is performed at enquiry centers as role of clinical trials.

Rehabilitation

Subsequently surgery, the joint surface must exist protected while the cartilage heals. If the procedure was done on your articulatio genus or ankle, you lot may not be able to put weight on the afflicted leg. You will need to use crutches to move around for the first few weeks after surgery.

Your medico may prescribe physical therapy. This will help restore mobility to the affected joint. During the first weeks later on surgery, you may begin continuous passive motion therapy. A continuous passive motion automobile constantly moves the joint through a controlled range of motion.

Equally healing progresses, your therapy will focus on strengthening the joint and the muscles that support it. It may be several months before you lot can safely render to sports activity.

Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. Nosotros apply both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to render our patients back to pain-free mobility and full force as quickly and painlessly equally possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-border, comprehensive care in the diagnosis and handling of orthopedic conditions, including full joint replacement and sports medicine. We apply the latest country-of-the-art techniques in order to return our patients to their active lifestyle.

If you're looking for compassionate, good orthopedic surgeons in Portland Oregon, contact OSM today.

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