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Plugging Away at Knee Treatment: Cartilage Transplants May Help
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Posted on: 11/30/1999
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Knee cartilage is very durable. It's strong enough to handle the repeated impact of running and jumping. But if you injure the ligaments in your knee, such as the ACL, your cartilage may become damaged as well. The injured ligament isn't able to hold the joint steady. Looseness in the knee may result in degenerative changes over time. Degeneration can cause defects (lesions) in the cartilage.
How can knee cartilage be repaired? Unfortunately, cartilage isn't vascular, meaning it doesn't get a lot of the blood and nutrients that help the body to heal. Doctors have tried to get cartilage to repair itself by drilling small holes into the bone just below it. They've also tried "roughing up" the tissue to stimulate healing. Recently, surgeons have begun replanting loose bits of cartilage in the knee. Results of these methods have been disappointing. Unless cartilage transplants are attached to bone, the tissue simply dies.
These authors tried taking tissue from elsewhere in the knee to plug up the lesions. The plugs were part cartilage, part bone. Ten patients with an average age of 40 had this procedure. They got one to three plugs each. The transplants were done arthroscopically through small incisions in the skin. An arthroscope is a small TV camera that allows doctors to see and work inside joints.
Up to a year after surgery, the transplants were alive and well. The plugs healed to surrounding cartilage. They looked and felt like normal cartilage. The areas where the cartilage had been taken out for transplant healed as well. There were no complications from surgery. Though this technique is still fairly new, the authors think it may be a good option for treating some kinds of cartilage defects.
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References:
F. Alan Barber, MD, and James C. Y. Chow, MD. Arthroscopic Osteochondral Transplantation: Histologic Results. In Arthroscopy. October 2001. Vol. 17. No. 8. Pp. 832-835.
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