Cartilage Restoration

That tough, resilient tissue covering the ends of your knee bones inside the joint helps the joint glide smoothly and cushions the shock during high impact activities. Articular cartilage does not appear to be alive, but in fact it is. Cells called chondrocytes live inside the cartilage matrix suspended in much the way marshmallows might be suspended in Jell-O. These cells only constitute 1 to 5% of articular cartilage but they have a critical role: keeping the complex matrix made of large molecules and collagen healthy. As the cartilage wears out, the chondrocytes repair it — in small quantities. But chondrocytes do not replicate. So once damaged or lost, these cells cannot repair the matrix and the cartilage matrix degenerates without some help. Our surgeons at The Cartilage Restoration Center of New Jersey can provide that help cartilage needs to start a healing response.

Early Intervention

In light of our discussion you can understand the importance of early intervention to prevent knee joint degeneration and arthritis. The CRCNJ provides several options for repair and/or regeneration.


Arthroscopic Chondroplasty and Microfracture

Surgeons locate the damaged articular cartilage tissue through 1/4 incharthroscopy incisions and stabilize the area with trimming. This prevents the damaged tissue from flaking off resulting in joint irritation, swelling and pain. We call this cleanup procedure a chondroplasty. Injuries smaller than 3/8 inch, or so, probably will not progress to further damage if nothing else is wrong with the knee. (What are some other “wrong things?” Some examples include loss of meniscal tissue, bow legs, or knock knees.)

In order to keep the lesion small and well defined we can stimulate the body to produce repair tissue by bringing some blood from the underlying bone to create some “scar” tissue. The surgeon uses a pick, drill or burr to create a microfracture. The tissue your body produces from this technique, fibrocartilage and not the more robust hyaline cartilage, keeps the small damage from spreading to the surrounding area much the way one would repair a pothole in the road to keep the rest of the road from damage. These pothole repairs will not last as long as a normal road but they do eliminate symptoms in many patients and may delay the progression to further degeneration.


Osteochondral Autografts

Analogous to a hair-plug transfer, the surgeon removes a small plug of your own cartilage along with some underlying attached bone. The plug comes from an area of your knee that does not carry much load. He then drills a receiving hole in the damaged cartilage area and transfers this bone and cartilage plug to that site. This plug is osteochondral, derived from “osteo” for bone and “chondral” for cartilage; this plug is also an autograft since the graft comes from your own body.

Of course the knee has limited tissue available for transplantation. Typically we take the transplant plugs from the edge of the trochlea where the patella glides. But if that area is damaged this technique may not be possible. These defects can be repaired in an area up to about the size of your thumbnail but not generally larger.