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Health Information Cartilage Restoration: Renewing Joints Without Replacing Them

 

 

 

 

Keep an eye out for outfielder Jose Martinez on a future Chicago White Sox roster. He's currently in the minors hitting .297 — no small feat when you consider the knee injuries he has sustained over the past two years.

In May 2009, Martinez had a meniscus transplant at Rush University Medical Center — home of the team physicians for the Chicago White Sox — to address his lingering pain and swelling following a meniscus removal and to help him return to his previous high level of play. After extensive rehab, Martinez is now back on the diamond chasing his dream of the majors.

As Martinez illustrates, knee pain isn't just for older adults. In fact, the majority of candidates for cartilage restoration techniques such as meniscus transplant are younger than 50: people too young for a joint replacement who want to resume their active lifestyles — even if they're not hoping to play at U.S. Cellular Field.

The inside story

 Inside healthy joints, smooth, white articular cartilage covers the ends of bones so they slide over each other easily. And inside each knee joint, two crescent-shaped pads of cartilage called menisci act as shock absorbers, cushioning every step.

But when cartilage becomes damaged or wears away, it leaves bone rubbing against bone, which causes pain and can lead to arthritis. Unfortunately, damaged cartilage does not heal, and the pain can worsen over time.

Typically, patients who come to see Brian Cole, MD, an orthopedic surgeon at Rush, are — like Martinez — in pain and relatively young. They'd like to remain active, but previous attempts to reduce their pain have failed. That's why leading orthopedic researchers, including those at Rush, have developed techniques to replace cartilage or stimulate new cartilage growth.

Meniscus transplant. Like Martinez, patients who have a meniscus transplant previously had most or all of their meniscus removed in an effort to address pain from damage. Partial meniscus removal does help some patients. For the rest, a transplant from a deceased organ and tissue donor, called an allograft, may do the trick. "Replacing the meniscus not only helps with pain, cushioning and stability, but it protects the knee's articular cartilage from additional stress," says Cole, who helped develop the specialized instruments and techniques for this procedure.

Neocartilage. Until recently, no viable treatments existed for rejuvenating damaged articular cartilage — a form of early arthritis that can worsen if untreated. To determine the best way to repair damaged articular cartilage, physicians at Rush are studying the rejuvenating power of juvenile cartilage (from deceased organ and tissue donors under age 13), which makes new cells more efficiently than adult tissue. Cells from this cartilage are grown and then implanted over the patient's damaged cartilage.

Microfracture. Another option for treating articular damage, microfracture involves making small holes in the damaged ends of bones. This process stimulates the body's own stem cells to form new cartilage at the site of the holes. Researchers at Rush are also studying a liquid made of fibrinogen, a purified blood component that may enhance this procedure. It is placed on the microfracture site and exposed to ultraviolet light, which hardens it to a gelatin-like consistency. Researchers hope this process will hold the stem cells in place longer and yield better cartilage growth.

Cartilage autograft implantation system. Clinicians at Rush helped develop this technique for treating articular cartilage damage, which uses a patient's cartilage from another joint. Clinicians mince the cartilage into small pieces, place the pieces on a web-like patch called a scaffold, and then implant it in the damaged joint. Cartilage regenerates itself on the scaffold, allowing the body to repair its own damaged joint from the inside.

Rejuvenated joints

Even if you're not heading to the big leagues, cartilage restoration may be able to turn back the clock for your damaged joints. To learn more about joint rejuvenation, call (888) 352-RUSH (7874).

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Just phone (888) 352-RUSH or (888) 352-7874 for help finding the doctor at Rush who's right for you.

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Cartilage Restoration: Renewing Joints Without Replacing Them
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