Cartilage Restoration: Exploring Surgical Options for Joint Preservation

Joints are remarkable structures that allow fluid movement and support our daily activities. However, they are not immune to wear and tear, injuries, and degenerative conditions. When the protective cartilage within our joints becomes damaged or deteriorates due to factors such as osteoarthritis, sports injuries, or age-related wear that causes knee pain, cartilage restoration becomes a critical need. 

So, let’s explore some of the cartilage restoration methods that changed the field of orthopaedics, allowing patients to regain mobility and function while reducing the need for more invasive interventions like joint replacement. 

1. Microfracture – Stimulating Cartilage Growth from Within

Microfracture is a minimally invasive surgical technique performed by a knee surgeon that stimulates the growth of new cartilage in areas where it has been damaged. It’s particularly effective for treating small to medium-sized cartilage defects in the knee joint, making it a popular choice for athletes and active individuals. The procedure involves creating small holes in the bone beneath the damaged cartilage using a specialised tool. This process, called “microfracturing,” encourages the release of bone marrow stem cells into the damaged area which then develops into fibrocartilage, acting as a cushion and providing some relief from joint pain and stiffness.

While microfracture is a promising option for cartilage restoration, it’s important to note that fibrocartilage isn’t as durable or resilient as the original hyaline cartilage. Patients who undergo microfracture may require periodic follow-up procedures or additional treatments to maintain their joint health.

2. Autologous Chondrocyte Implantation (ACI) – Cultivating New Cartilage

Autologous Chondrocyte Implantation (ACI) is an intricate procedure that offers a more permanent solution for cartilage repair. It is particularly beneficial for patients with larger cartilage defects or those whose microfracture procedure has been unsuccessful. The treatment begins with the extraction of healthy cartilage cells (chondrocytes) from a non-weight-bearing area of the patient’s own joint. These chondrocytes are then cultured and multiplied in a laboratory setting to create a sufficient number of cells for implantation. Once an adequate quantity is obtained, the cultured chondrocytes are surgically implanted into the damaged area, facilitating the growth of new cartilage.

The key advantage of ACI is the production of hyaline-like cartilage, which closely resembles the natural cartilage found in our joints. This type of cartilage is more durable and offers superior shock-absorbing properties compared to fibrocartilage, making it an excellent choice for long-term joint preservation.

3. Osteochondral Autograft Transplantation (OAT) – Restoring Joint Surfaces

Osteochondral Autograft Transplantation (OAT), commonly employed in knee surgery, is a surgical technique meticulously designed to restore both the cartilage and underlying bone within a damaged joint. This method proves particularly effective for patients grappling with small to medium-sized defects in weight-bearing areas of the joint, with a primary focus on knee-related issues. During an OAT procedure, healthy cartilage and bone are harvested from a patient’s own joint that doesn’t bear weight. This graft is then transplanted into the damaged joint, precisely fitting the contours of the defect. OAT is a solution to consider because it not only restores the joint’s surface but also maintains the natural bone-cartilage interface.

4. Matrix-Associated Chondrocyte Implantation (MACI) – Enhanced Cartilage Regeneration

Matrix-Associated Chondrocyte Implantation (MACI) is a relatively newer technique that combines the benefits of ACI with the support of a matrix or scaffold. This approach enhances the ability of chondrocytes to regenerate cartilage effectively. In a MACI procedure, cultured chondrocytes are embedded within a three-dimensional scaffold or matrix, designed to mimic the structure of healthy cartilage. This construct is then implanted into the damaged joint, filling the defect and providing structural support for the regenerating cartilage. The matrix gradually breaks down as the chondrocytes mature, leaving behind a newly formed, hyaline-like cartilage.

MACI offers a more controlled and predictable method for cartilage restoration, making it an attractive option for patients seeking lasting joint preservation.

These cartilage restoration techniques represent significant advancements in the world of orthopaedics, offering individuals a chance to regain their quality of life despite joint issues. So, if you are experiencing joint pain or are suffering from cartilage damage, consult with our qualified knee specialists who will guide you towards the most suitable treatment path. At Advanced Orthopedics and Sports Centre, we specialise in comprehensive orthopaedic care, including cartilage restoration techniques.

Don’t let joint issues hold you back from the activities you love. Contact us today to know more!