Articular Cartilage Repair

What is an articular cartilage and how can it get damaged?

Articular cartilage can be imagined as a lubricated cushion that covers the ends of the joint-forming bones. It reduces friction and provides a smooth surface for the joint as it bends and transmits weight. Articular cartilage is 2 to 4 mm thick and is composed of water, collagen, proteins, and cartilage cells, also known as chondrocytes. Cartilage is not supported by any nerves or blood vessels, and, therefore, has a low capacity to repair itself after damage. Elbows, wrists, ankles, and shoulders can all suffer cartilage damage, however, the knee joint is the one that gets damaged the most.

What are the treatment options for someone with articular cartilage damage?

There are a few surgical techniques used to treat articular cartilage damage. Bear in mind that the best treatment option will be chosen individually after a consultation with an orthopaedic surgeon.

JointRep is a type of orthopedic implant which is composed of artificial biopolymers. JointRep is a unique type of treatment because it can be performed arthroscopically with just a few small incisions. The implant is in liquid form, therefore, it can be injected directly into the area and smoothly cover damaged cartilage. When injected, the implant solidifies into a gel-like substance which is full of sugar, glucosamine and water. These constituents stimulate the growth of a new healthy cartilage.

Lipogems is a method that works by stimulating regeneration of the cartilage. It is unique because the patient’s own fat is used to treat the damaged cartilage. Fat cells, also known as adipocytes, have regenerative properties, and, thus, can function as stem cells in the formation of new cartilage. Firstly, fat is obtained from the abdomen, hands, or thighs. It is then purified, cleaned and injected into the joint where it works on repairing damaged tissue.

• If articular cartilage repair is performed on the knee or ankle joint, a person will not be able to step on the operated leg for at least a few weeks. The first recovery phase is a passive motion therapy.
• Crutches are needed for up to six weeks post-surgery.
• A continuous passive motion machine, which stimulates synovial fluid production and blood supply to the joint, is used to move the joint without putting on weight.
• Majority of the patients can return to work in a week or two after the surgery. Patients are prescribed physical exercise routine which they have to follow for up to 3 months post-surgery. Physical therapy focuses on improving the strength of the muscles around the joint, which subsequently reduces pressure on the cartilage.
• Sportspeople can return to active training in 4 months after the surgery.

Rehabilitation is just as important as the surgery itself, and thus, articular cartilage repair patients have to follow a detailed recovery plan which is designed to help them regain mobility and live an active lifestyle again. Most people are able to return to moderate physical activities after 6 to 8 weeks, however, full recovery should be expected after 3 to 6 months.

Is articular cartilage repair permanent or does it require further treatment?

The outcome of articular cartilage repair surgery depends on the extent of cartilage damage and on how successful the recovery process is. Approximately 80 % of cartilage repair surgeries are successful. A follow-up care includes close monitoring of new cartilage development through MRI imaging. MRI (Magnetic Resonance Imaging) is a non-invasive means to check on the healing process. MRI is safe and does not emit any radiation because neither X-rays or other radiation is used.